Hemorrhoids or Colorectal Cancer?

    Because both can cause rectal bleeding, patients frequently worry about this distinction. Symptoms overlap, and the two conditions can also coexist, which is why self-diagnosis is unreliable.

    Findings more suggestive of hemorrhoids

    • Bright red blood on the paper or dripping after defecation
    • Itching, a sensation of swelling or a reducible lump
    • Symptoms fluctuating with constipation or straining

    Findings that require prompt investigation

    • Blood mixed within the stool or dark, tarry stools
    • Persistent change in bowel habit or pencil-thin stools
    • Unintended weight loss, fatigue or anaemia
    • New symptoms after the age of 45–50
    • Family history of colorectal cancer or polyps

    Why both can be present

    Finding hemorrhoids on examination does not exclude a lesion higher in the colon. When risk factors or alarm features are present, colonoscopy is advised even if hemorrhoids are visible.

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