Blood During Bowel Movements: Is It Hemorrhoids or Colon Cancer?

Bleeding during bowel movements?

Hello Doctor: I would like to ask you, recently my stools have been very hard, and it hurts a bit when I pass them.
There is fresh blood when I wipe, and the amount seems to be quite significant.
This has been ongoing for a week, and I am worried whether this could be a sign of hemorrhoids or a precursor to colon cancer.
Please help me with this! Thank you!

Highker, 20~29 year old female. Ask Date: 2010/03/16

Dr. Chen Bozhang reply Family Medicine

Hello,
In response to your question, colorectal cancer typically occurs in individuals aged 50 and older, and it is generally less likely to consider the possibility of colorectal cancer at the age of 24.
The symptoms of pain during bowel movements accompanied by a small amount of bright red blood are characteristic of anal fissures, especially when there is also hard stool.
Based on your description, it is more likely that you are experiencing an anal fissure.

The treatment should prioritize topical ointments and suppositories, along with addressing constipation by increasing fiber intake or using stool softeners, which should be helpful.
Additionally, warm sitz baths offer three benefits for anal fissures: they maintain cleanliness, promote blood circulation, and the warmth can relax the anal sphincter, alleviating pain and accelerating wound healing.
It is recommended to perform sitz baths at least three times a day, which should significantly aid in symptom improvement.
Wishing you a speedy recovery.
Dr.
Ke Fang-Hsu, Department of Surgery, Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2010/03/16

More Info

When experiencing blood during bowel movements, it is understandable to feel concerned, especially given the potential implications of such symptoms. Based on your description, it seems that you are dealing with hard stools that cause pain during defecation, and you notice fresh blood upon wiping. This situation raises important questions about whether the cause is hemorrhoids or something more serious, such as colon cancer.

Firstly, it is crucial to recognize that hemorrhoids are a common cause of rectal bleeding, particularly when associated with hard stools. Hemorrhoids can become inflamed or irritated, especially if you are straining during bowel movements due to constipation. The blood associated with hemorrhoids is typically bright red, which aligns with your observation of fresh blood when wiping. Additionally, hemorrhoids can cause discomfort or pain during bowel movements, which you are also experiencing.

On the other hand, while colon cancer can also present with rectal bleeding, it is generally accompanied by other symptoms, such as changes in bowel habits (like persistent diarrhea or constipation), unexplained weight loss, abdominal pain, or a feeling of incomplete evacuation. The fact that you are experiencing hard stools and pain suggests that your symptoms may be more aligned with hemorrhoids rather than colon cancer, especially if you do not have any of the other concerning symptoms mentioned.

However, it is essential to consider your personal and family medical history. If there is a history of colon cancer in your family, or if you have other risk factors (such as age, lifestyle, or previous gastrointestinal issues), it is prudent to be more vigilant. While your symptoms may suggest hemorrhoids, it is always better to err on the side of caution.

Given that your symptoms have persisted for a week, I strongly recommend that you consult with a healthcare professional, preferably a gastroenterologist or a colorectal surgeon. They can perform a thorough examination, which may include a digital rectal exam or even a colonoscopy, to rule out any serious conditions and provide you with a definitive diagnosis.

In the meantime, consider making some dietary and lifestyle changes to help alleviate your symptoms. Increasing your fiber intake through fruits, vegetables, and whole grains can help soften your stools and reduce straining during bowel movements. Staying well-hydrated is also essential. If necessary, over-the-counter stool softeners or laxatives can be used to ease your bowel movements, but these should be used sparingly and under the guidance of a healthcare provider.

In summary, while your symptoms may indicate hemorrhoids, it is crucial to seek medical advice to rule out any serious conditions, including colon cancer. Early intervention and proper management can significantly improve your quality of life and address any underlying issues effectively. Please do not hesitate to reach out to a healthcare professional for a thorough evaluation and personalized care.

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