Hemorrhoids & Colon Cancer Symptoms: How to Tell the Difference

Dealing with pain or bleeding in the rectal area isn't particularly uncommon, but many people avoid talking about it. That uneasiness can make it difficult to decide when it's time to call your doctor about symptoms involving the rectum or anus.

In many cases, the source is an easily treatable condition such as hemorrhoids. But similar symptoms also can be a warning sign of colorectal cancer.

So how do you know when rectal discomfort might be a sign of something serious? Dr. Kirtan Nautiyal, a gastrointestinal medical oncologist at Houston Methodist, is here to break the differences down. He says the first step is understanding the facts about hemorrhoid and colon cancer symptoms.

Understanding hemorrhoids

If you have hemorrhoids, you're not alone — it's the third most commonly diagnosed gastrointestinal condition. About half of adults over age 50 get hemorrhoids at least once. In fact, as many as 4 million Americans visit their primary care provider or even the emergency room with hemorrhoid symptoms.

Hemorrhoids develop when the veins and sensitive tissues of the anus or lower rectum become inflamed. This can happen when blood flow through this area becomes restricted for one reason or another. The specific diagnosis depends on where the inflammation arises:

• Internal hemorrhoids occur inside the rectum, where your body stores stool until it's ready to pass
• External hemorrhoids affect the anus, the opening where the stool comes out

What are the symptoms of hemorrhoids?

Hemorrhoids are also known as "piles" because the swollen veins can cause pockets of skin to prolapse, or protrude, around the anus. These appear as small lumps that you can feel when wiping or showering.

"You might feel a lot of itching or irritation in the anus area, and you might have painful bowel movements," says Dr. Nautiyal. The most alarming sign can be spots of bright red blood on the toilet tissue when you wipe or on the stool itself.

What causes hemorrhoids?

There are several reasons why you might develop hemorrhoids:

• Straining during bowel movements
• Sitting on the toilet for long periods of time
• Chronic constipation or diarrhea
• Eating a low-fiber diet
• Lifting heavy objects
• Being very overweight (obesity)
• Being pregnant

(Related: High-Fiber Foods to Help You Get More Fiber In Your Diet)

Understanding colon cancer

Your colon forms the upper part of your large intestine. This area is where your body absorbs water and nutrients, and it's also where the leftover waste products turn into stool. From there, stool moves into the rectum, where your body stores it until you have a bowel movement.

Colorectal cancer develops when abnormal cells in your colon or rectum begins to grow out of control. The cancerous cells might start as small growths called polyps that grow on the lining of the colon or rectum. If undetected, the cancerous cells will form into a tumor that grows into the wall of the colorectal tract.

Colorectal cancer is the third most common type of cancer in the U.S. Though its prevalence has been declining among older adults since the 1980s, the rate of colorectal cancer in people younger than 50 has been climbing over the past decade. (Related: PODCAST: Why Are Younger Adults Getting Diagnosed With Colorectal Cancer?)

What are the symptoms of colon cancer?

Colorectal polyps and early stages of colorectal cancer don't always cause symptoms. People who develop colorectal cancer may notice these warning signs:

• Changes in consistency or frequency of bowel movements
• Blood in the stool
• Abdominal or pelvic pain
• Unexplained weight loss

As with many types of cancer, the risk of colorectal cancer increases with age. It's more prevalent in men than in women, and African Americans are 20% more likely to develop colorectal cancer.

"Family history is a big risk factor for colorectal cancer," says Dr. Nautiyal. "We also see higher rates in people living with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis."

There's also evolving knowledge about the connection between diet and colorectal cancer risk.

"This hasn't been fully teased out yet," explains Dr. Nautiyal. "Some evidence points to a link between colorectal cancer and having a low-fiber diet or eating a lot of processed meats, such as sausages and cold cuts."

(Related: PODCAST: Should You Put That Hot Dog Down?)

Is there a connection between hemorrhoids and colorectal cancer?

Are hemorrhoids a sign of colon cancer? Dr. Nautiyal says no — there is no proven link between hemorrhoids and any form of colorectal cancer. However, both conditions share some of the same symptoms.

While rectal bleeding causes the most concern for people, there are a few differences you should know:

• Bleeding associated with hemorrhoids happens during and after bowel movements. The spots of blood are usually bright red, as you'd see with a minor cut on your skin.
• Cancer-related bleeding can occur at any time, even when you're not having a bowel movement. The blood might be darker or have a tarry texture.

Most episodes of hemorrhoids resolve on their own with lifestyle changes or medication. Your doctor will want to know if you have symptoms for more than a week or if you have any new bleeding.

In addition to similar symptoms, hemorrhoids and colorectal cancer also share several lifestyle-related risk factors. You can help reduce your risk of both conditions by choosing a high-fiber diet (which can make having bowel movements easier), increasing your physical activity and maintaining a healthy weight.

Screening for colon cancer

The best way to prevent colorectal cancer is to get regular screenings as recommended by your doctor. The gold standard of colon cancer screening is a colonoscopy. During this outpatient procedure, a specialist uses a flexible, lighted tube to examine the interior of the rectum and colon. (Related: Can a Blood Test Detect Colon Cancer?)

"When we can catch cancer early, it means better outcomes with less intensive treatment," says Dr. Nautiyal. "If you have pre-cancerous polyps, we can often find and remove them during the colonoscopy before they turn into something more serious."

The guideline for starting regular colonoscopies is now age 45 for adults with average risk. If no polyps or other anomalies are found, your doctor will typically recommend additional screenings every 10 years. Your doctor may recommend screenings starting at a younger age or more frequently if you have a family history of colorectal cancer or if you live with inflammatory bowel disease (IBD).

Talk about symptoms with your care team

Many people find it awkward to talk about bowel movements and other sensitive topics. Dr. Nautiyal reminds patients that these body parts and functions need the same attention as other medical concerns.