Category Archives: Anal Cancer

10 Reasons For Rectal Bleeding That Aren’t Hemorrhoids | Minnesota

Bleeding from your rectum or anus is never a pleasant experience, and it can understandably cause immediate panic. Generally, bright red blood indicates bleeding in the lower rectum, while dark red blood indicates bleeding from deeper and further up in the body. While passing dark red blood is usually a sign of digestive bleeding and requires immediate attention, any amount of rectal bleeding should be taken seriously.

While rectal bleeding can be caused by pesky hemorrhoids, there are a number of other potential causes ranging from fistulas and fissures to more serious cases of colon/bowel cancer.
 
1. Anal Fistula
An anal fistula is an inflammatory tunnel under the skin connecting the anal canal and the surface of the surrounding skin. Most fistulas occur from an anorectal infection, where the anal crypts are infected and cysts containing pus form near the anal canal. Fistulas are often misdiagnosed as hemorrhoids, as symptoms can be similar, including drainage from the anus, itchiness and pain during bowel movements. They can be treated with antibiotics, pain meds and a fistulotomy.

2. Anal Fissure
An anal fissure is a small rip or tear in the lining of the anal cana typically caused by trauma to the inner lining of the anus via a bowel movement or stretching of the anal canal. They can be painful, but fissures often heal within a few weeks through increasing fiber/fluid intake to keep stool soft and help ease bowel movements.

3. Colon Cancer
As scary as it may sound, rectal bleeding is a dangerous sign of colon cancer and must be taken very seriously. Symptoms of colorectal cancer include abdominal pain, a change in bowel habits, an anal or rectal lump, and bleeding during bowel movements. Click here to read our post on the differences between rectal cancer and hemorrhoids.

4. Gastroenteritis
Gastroenteritis, otherwise known as the stomach flu, is a common bacterial infection that causes diarrhea, fever and vomiting. Due to inflammation in the stomach and colon, the bowel becomes more sensitive during the illness and may cause bloody stools. While the process is uncomfortable, gastroenteritis normally clears up after a few days of rest and hydration.

5. Diverticulosis
Diverticulosis is a chronic bowel condition that causes small bulges or pockets to develop in the lining of the intestine/digestive tract. If these bulges become inflamed or infected, abdominal pain, bloating, constipation, diarrhea, and bloody stools can occur. More common in people over 40, diverticulosis can be treated using diet modifications, antibiotics and, if needed, surgery.

6. Rectal Prolapse
Believe it or not, a bit of your intestine can actually slip outside of your body. A rectal prolapse occurs when part of the large intestine slips outside the anus, which can happen during a bowel movement. This in turn causes pain and bright red blood in the stool, as well as difficulty in controlling your bowel movements. A prolapse usually requires surgical treatment, so call your doctor right away.

7. Polyps
Polyps are non-cancerous growths that can develop along the lining of your bowel. They’re pretty common and don’t usually manifest symptoms. In more severe cases, they can cause diarrhea, constipation, mucus in the stool and bloody stools. While most polyps do not escalate into cancer, there is still risk of cancer development. Be sure to call your doctor for a full examination.

8. Internal Bleeding
As mentioned earlier, darker colored blood can be a sign of internal bleeding in your digestive system. It can also be a sign of cancer, stomach ulcers or severe gastrointestinal disease. If you see dark red blood in your stool call your doctor ASAP.

9. Colitis
Colitis is a chronic inflammation of the innermost lining of the large intestine and rectum. Small ulcers develop in the lining of the bowel, which then bleed and produce pus. This causes recurring diarrhea, abdominal pain, rectal bleeding, and the frequent urge to pass stools. Management of colitis conditions can include antibiotics, medications and surgery.

10. Sexually Transmitted Infection (STI)
Sexually transmitted infections (STI) can result from unprotected anal sex and cause inflammation of the lining of the anus, which can lead to bleeding and pus. Treatment includes antibiotics and antiviral/antifungal medications.

 

Hemorrhoids vs. Rectal Cancer: How to Tell the Difference | Minnesota

Because the symptoms of hemorrhoids and early-stage rectal/colon cancer are very similar, people often confuse and, at times, misdiagnose the two conditions. Since the treatment method for each condition is vastly different, it’s important to know how to differentiate hemorrhoids from rectal cancer and proceed with the appropriate treatment options.

Rectal Cancer

The most obvious and noticeable symptom of rectal cancer is a malignant tumor (cancerous tumor that spreads) that forms in the tissues of the rectum. Additional rectal cancer symptoms can include:

  • Stools that are not round in shape
  • Bloody stools
  • A change in bowel habits (diarrhea, constipation)
  • Anal tenesmus (the feeling of urgently and constantly needing to pass stools due to rectal inflammation)
  • Unexplained weight loss (typically later symptom)
  • Unexplained fatigue (typically later symptom)
  • Pelvic or lower abdominal pain (typically later symptom)
  • The risk of rectal cancer increases as you age, so the condition is more common in individuals over 50, although it can also manifest in younger people. Those with either a personal or family history of colorectal polyps, colorectal cancer or inflammatory bowel disease (IBD) are at a higher risk.

    If you have any of above symptoms, you’ll need to still see a doctor for a digital rectal exam, colonoscopy and full work-up.
     

    Hemorrhoids

    Hemorrhoids are swollen, bulging blood vessels in the walls of the anus and lower rectum. When the tissues supporting the vessels become inflamed and stretch, the vessels expand and cause its walls to thin. This often leads to bleeding. If the intense stretching and internal pressure continue, these already weakened vessels ultimately protrude from the anus. Patients with hemorrhoids can suffer from internal hemorrhoids, external hemorrhoids, or both.

    Internal hemorrhoids are small or large hemorrhoids that develop inside the rectum and do not protrude outside the anus. They may bleed but are normally painless.

    External hemorrhoids are small or large hemorrhoids that protrude from the anus and bleed. Some external hemorrhoids retract back into the anal sphincter after a period of time, while larger, more severe ones require manual pushing to force them back into the interior of the anus. Hemorrhoids can exit the body via coughing, sneezing, laughing or standing for long periods of time. Prolapsed hemorrhoids can produce external anal mucus and itching around the anus.

    Symptoms of hemorrhoids include:

  • Discomfort, itching or pain around your anus
  • Bloody stools or seeing blood on the toilet paper when wiping
  • Moist, pink bumps around the edge of the anus, or bulging out from the anus
  • Severe or abnormal pain (advanced hemorrhoids)
  • Discomfort when sitting and laying down (advanced hemorrhoids)
  • Unlike rectal cancer, hemorrhoids are typically caused by changeable lifestyle habits such as lack of movement and exercise (lack of blood circulation), sedentary work, and straining from constipation, as well as pregnancy.

    If you experience any of the above rectal cancer or hemorrhoid symptoms, see a doctor immediately. For more on rectal examinations, check out our blog post about what to expect from a standard rectal exam.

     

    Need to be a high suspicion of anal cancer if patients have rectal symptoms | Minneapolis & St Paul

    Patients with anal cancer often mistakenly think that the rectal symptoms are caused by hemorrhoids, which lead to a significantly delayed diagnosis. Even when patients seek medical attention, anal cancer is often misdiagnosed as hemorrhoids. It is important to have a high suspicion of anal cancer if patients have rectal symptoms.

    Anal cancer is account for 2% of cancer in the gastrointestinal tract. It usually refers to anal squamous cell carcinoma. Anal squamous cell carcinoma is a disease associated with human papillomavirus (HPV). The anal cancer develops from the inflammation of squamous cells in the anal canal, which is the space that connects the rectum to the outside of the body. This is inflammation is often believed to be caused by HPV. Squamous cell cancer makes up the majority of cases of anal cancer- about 80%. Cancer types other than squamous cell carcinoma are varied and rare, accounting for only a minority of anal cancer.

    Symptoms
    Anal or rectal cancer generally do not produce any pain; an external or internal mass may be palpable. Some lesions are so soft that they are missed on palpation. Common symptoms include anal/pelvic pain and anal bleeding (seen in about half of patients), sensation of a mass in the rectum (seen in about a third of patients), local sensations of wetness/irritation, prolaps, rectal incontinence, and severe constipation.

    About 19% of patients wait 6 months to see a doctor after initial symptoms. To further complicate things, about 27% of patients end up initially receiving treatment for misdiagnosed anorectal diseases with similar symptoms like hemorrhoids. Anal cancer has a very long lag time between symptoms and diagnosis due to reluctance or denial, often out of shame/embarrassment, or fear.

    Risk factors for anal cancer include active HPV infection, smoking, receiving anal sex, immunosuppression, HIV infection, and organ transplant. Risk is particularly high if one has two or more of these factors.

    Treatment
    Surgery plays a limited role in the treatment for anal cancer. Surgery is indicated in anal cancer with very early stage, such as T1, N0, well-differentiated lesions in the anal margin.

    For the majority of patients diagnosed with anal squamous cell carcinoma, treatment will consist of radiation therapy combined with radiosensitizing chemotherapeutic agents. These treatments can caused the complications that affect the anal cancer patient, including the short-term adverse effects of chemotherapy and long-term risks of radiation exposure.

    Conservative management of symptoms include lifestyle changes and bulking agents and anti-diarrheal agents.

    Vaccination against HPV serotypes 16 and 18, which are believed to cause the majority of cases, is the best way to prevent the development of anal cancer.

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