Is Rectal Bleeding a Sign of Hemorrhoids or Colon Cancer?

Is rectal bleeding from hemorrhoids or colorectal cancer?

Recently, my bowel habits have changed; sometimes I have a bowel movement and sometimes I don't (possibly due to not eating vegetables?).
I don't have a regular bowel schedule, but I don't experience the urge to go without being able to, and I don't have constipation issues—it's just that my bowel movements are infrequent.
I often feel bloated because, as a student, I sit for long periods and don't get enough exercise.
I only started weight training recently after finishing exams.
My eating habits are very picky; I hardly eat vegetables and mostly consume some fruits, with a higher intake of red meat.

In my last two bowel movements, I noticed blood in my stool; it was somewhat watery due to diarrhea, and there was a very small amount of dark red blood that seemed to cover about 1% of the stool from above.
The blood was mixed in, and I haven't experienced any itching or pain.
Currently, there is no pain or sensation of a foreign body.
My weight hasn't decreased, and I don't feel fatigued or anemic.
I am 18 years old, 180 cm tall, and weigh 70 kg.

I would like to know if this could be a sign of internal hemorrhoids or colorectal cancer.
I found that both conditions partially match my symptoms, and I'm a bit scared.
What condition could this be? Do I need to get checked? If so, what kind of examination should I do first?

Ming, 10~19 year old female. Ask Date: 2023/03/26

Dr. Zhang Shuhao reply Surgery

Bleeding during bowel movements in young individuals is often due to anal conditions such as hemorrhoids and anal fissures; however, colorectal cancer can also present with similar symptoms, making it difficult to distinguish between them.
It is recommended to visit a colorectal clinic for evaluation.
A digital rectal examination and anoscopy can help identify anal disorders and check for any rectal lesions.
If the source of bleeding cannot be determined, or if there are other risk factors, a colonoscopy should be arranged.

Reply Date: 2023/03/26

More Info

Rectal bleeding can indeed be concerning, and it is understandable that you are worried about the potential causes, including hemorrhoids and colon cancer. Based on the information you provided, let's break down the symptoms and possible explanations.

Firstly, the presence of blood in your stool can arise from various sources within the gastrointestinal tract. Hemorrhoids, which are swollen blood vessels in the rectal area, are a common cause of rectal bleeding, especially if the blood is bright red and appears on the surface of the stool or on toilet paper. Symptoms of hemorrhoids may also include itching or discomfort around the anus, which you mentioned you do not have.
On the other hand, colon cancer can also present with rectal bleeding, but it typically comes with other symptoms such as changes in bowel habits, unexplained weight loss, persistent abdominal discomfort, or a feeling that the bowel does not empty completely. Given that you are 18 years old, the likelihood of colon cancer is relatively low, especially if you do not have a family history of the disease or other risk factors.

Your dietary habits, particularly your low intake of vegetables and high consumption of red meat, can contribute to gastrointestinal issues. A diet lacking in fiber can lead to constipation and hard stools, which can cause small tears in the rectal lining (anal fissures) or exacerbate hemorrhoids, leading to bleeding. Additionally, the fact that you mentioned changes in your bowel habits and occasional diarrhea could indicate that your gastrointestinal system is reacting to your diet.

The blood you observed, being dark red and mixed with stool, might suggest that it is coming from higher up in the gastrointestinal tract, but it could also be from hemorrhoids or fissures if the stool is hard. Since you have not experienced pain, itching, or other alarming symptoms, this may lean more towards hemorrhoids or minor fissures rather than colon cancer.

Given your age and the absence of alarming symptoms, it may not be necessary to panic. However, it is advisable to consult a healthcare professional for a thorough evaluation. A gastroenterologist can provide guidance on whether you need a physical examination or further tests. Typically, a digital rectal exam can be performed first to check for hemorrhoids or fissures. If necessary, they may recommend a colonoscopy, especially if symptoms persist or worsen.

In the meantime, consider making dietary changes to increase your fiber intake, which can help regulate your bowel movements and reduce the risk of hemorrhoids. Incorporating more fruits, vegetables, and whole grains into your diet can be beneficial. Staying hydrated and maintaining regular physical activity can also improve your digestive health.

In summary, while rectal bleeding can be a sign of both hemorrhoids and colon cancer, your age and the nature of your symptoms suggest that hemorrhoids or minor fissures are more likely. Nevertheless, it is essential to seek medical advice to rule out any serious conditions and to receive appropriate care.

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