Hemorrhoids and colon cancer are two very different conditions, but they can share some similar symptoms.
Discovering blood on toilet tissue or in the bowl can be alarming. You may be embarrassed to discuss it with your doctor. Remember, however, that doctors are familiar with these issues. It’s not only important to talk to your clinician; it could be a lifesaving conversation.
“Prompt medical evaluation and screening are crucial when symptoms like rectal bleeding appear,” says Sarah Choi, MD, a colorectal surgeon with the USC Colorectal Surgery Program, part of Keck Medicine of USC.
Symptoms like rectal bleeding could be signs of hemorrhoids or colorectal cancer. About half of adults experience hemorrhoids by age 50. The lifetime risk of colorectal cancer, meanwhile, is only about 4%.
Hemorrhoids and colorectal cancer share several symptoms. Because these symptoms can be similar, professional evaluation is essential for proper diagnosis and peace of mind — especially because, in cases of colorectal cancer, cancer may have already begun to spread by the time symptoms emerge, Dr. Choi says. Identifying the condition early not only helps reduce your anxiety but also makes treatment easier.
What are the symptoms of hemorrhoids?
Hemorrhoids are swollen veins in the anus and rectum that can be internal or external. They typically cause noticeable symptoms during occasional flare-ups, often during or after bowel movements. Common signs include:
- Bright red blood on toilet paper or in the toilet
- Itching or irritation around the anal area
- Lumps you can feel or see near the anus
- Pain or discomfort, especially during bowel movements
“Many patients come to me worried that their symptoms might be cancer,” Dr. Choi says. Even after a hemorrhoid diagnosis, they often ask if hemorrhoids can turn into cancer. “Having hemorrhoids chronically can lead to increased inflammation or irritation in the anal canal, but there are no studies showing that it directly can turn into cancer itself,” she says.
Hemorrhoids risk factors
While their exact cause is unknown, several factors can increase your risk of developing hemorrhoids:
- Chronic constipation or diarrhea
- Lifting heavy objects without proper technique
- Obesity
- Pregnancy
- Prolonged standing or sitting (especially on the toilet)
- Straining during bowel movements
How are hemorrhoids diagnosed and treated?
Diagnosing hemorrhoids is typically straightforward. The process includes taking a medical history; performing a physical exam, which includes inspecting the rectum; conducting a digital rectal exam; as well as performing an anoscopic exam to look at the hemorrhoids themselves.
Once diagnosed, hemorrhoids usually aren’t dangerous but can be uncomfortable. In many cases, symptoms will improve within a few days with home treatment. Doctors recommend:
- Sitting in a lukewarm bath
- Alternating moist heat with ice
- Limiting extended time sitting
- Using over-the-counter topical creams and suppositories
- Using scent- and dye-free toilet paper
- Keeping the area clean
More serious cases may require additional treatment options, from minimally invasive in-office procedures to surgery, to remove the troublesome blood vessels.
What are the symptoms of colorectal cancer?
Unlike hemorrhoids, colorectal cancer symptoms often indicate advanced disease. Colon cancer, also known as colorectal cancer, is a malignant tumor arising from the inner wall of the large intestine. Dr. Choi underscores that early-stage colorectal cancer often lacks obvious warning signs, which is why regular screening is critical.
When symptoms develop, they may include:
- Abdominal pain or cramping that doesn’t go away
- Blood in the stool (which can appear bright red, dark or tarry)
- Changes in bowel habits
- Feeling as though your bowels don’t empty completely
- Feeling tired or weak
- Weight loss without trying
Symptoms are similar for men and women. It should also be noted that people who menstruate and develop anemia from colon cancer may experience irregular menstrual cycles. Having these symptoms doesn’t always mean cancer, but their persistence or worsening warrants prompt medical attention.
Colon cancer risk factors
According to the American Cancer Society, researchers are unsure of the exact cause of colon cancer, but certain factors may increase your risk. Some risk factors are shared with hemorrhoids:
- Age (risk increases after 50)
- Family history of colorectal cancer or polyps
- Obesity
- Personal history of inflammatory bowel disease
Additional risk factors specific to colorectal cancer include:
- Crohn’s disease
- Inherited genetic conditions
- Low-fiber diet
- Type 2 diabetes
- Ulcerative colitis
How is colorectal cancer diagnosed?
In diagnosing colorectal cancer, physicians use more extensive testing. The primary screening tool is a colonoscopy, which allows doctors to look for growths (polyps) in the colon. Dr. Choi describes that “the colonoscopy is both diagnostic and therapeutic. If we see any polyps during the colonoscopy, we remove them,” and they are biopsied to determine if they are cancerous. “Not all polyps become cancer,” she continues, “but having the polyp will increase your risk of having cancer because one of the polyps can turn into cancer.”
While other screening options exist, including stool-based tests and DNA tests, Dr. Choi emphasizes that if these tests come back abnormal, you would still need a colonoscopy. The advantage of starting with a colonoscopy is that it can prevent cancer by removing suspicious polyps during the procedure. In any case, if cancer is found, treatment depends on how early it is found, but it may include surgery, radiation, chemotherapy and targeted therapies.
The American Cancer Society recommends those at average risk start regular screenings at age 45. However, if you have a first-degree relative with colorectal cancer (parents, siblings or children), you should begin screening at age 40 or 10 years before your relative’s diagnosis age, whichever comes first. Someone with second-degree relatives with colorectal cancer or polyps (aunts, nephews, grandchildren, half-siblings) should begin screening at age 40. When caught early through screening, colon cancer has a five-year survival rate of 91%.
Steps you can take to reduce your risk
Modifying your lifestyle can help reduce your risk of both colorectal cancer and hemorrhoids, Dr. Choi advises. She recommends maintaining a high-fiber diet (25-35 grams daily from whole grains, fruits, vegetables or fiber supplements), but she also notes that dietary sources alone often aren’t sufficient. She also suggests reducing your consumption of red and processed meats. Regular exercise is crucial, and even simple walking helps improve bowel motility.
“I know a lot of people escape to the toilet to be on their phone or read the news,” she points out. Sitting on the toilet for extended periods increases pressure in the anal area, which can lead to hemorrhoids. “No more than five minutes on the toilet,” she advises.
Other important steps include maintaining a healthy weight, engaging your core muscles when lifting heavy objects and getting screened at recommended intervals. She also emphasizes avoiding or limiting behaviors that increase risk: quit smoking and limit alcohol intake. These lifestyle adjustments, while simple, are a proactive step to protect your health and may help reduce your risk of hemorrhoids or colorectal cancer.
If you notice blood when using the bathroom, don’t panic — it’s often harmless — but getting checked out is important. A prompt evaluation provides peace of mind, and early detection saves lives. Your doctor can determine the cause and recommend appropriate screenings or lifestyle changes.
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