Hemorrhoids vs. Rectal Cancer: How to Tell the Difference

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.