Rectal Bleeding: Hemorrhoids or Colon Cancer? - Surgery

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Rectal bleeding


A week ago, after having a bowel movement, there was a significant amount of blood on the toilet paper, but the stool itself did not have blood.
Since then, I have been experiencing frequent abdominal pain, and in the last two days, I've noticed some difficulty urinating, requiring abdominal straining to do so.
Could this be bleeding from hemorrhoids or colon cancer?

C, 10~19 year old female. Ask Date: 2015/10/15

Dr. Ke Fangxu reply Surgery


This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
You may also consider purchasing over-the-counter hemorrhoid suppositories for use.
However, if bleeding persists, it is best to consult a physician for evaluation.

Reply Date: 2015/10/15

More Info


When it comes to rectal bleeding, it can be a source of significant concern for many individuals, especially when accompanied by other symptoms such as abdominal pain or changes in bowel habits. Based on your description, it is essential to consider both hemorrhoids and more serious conditions like colon cancer as potential causes of your symptoms.

Firstly, the presence of bright red blood on toilet paper after a bowel movement is often associated with hemorrhoids, particularly internal hemorrhoids. Hemorrhoids are swollen blood vessels in the rectal area that can bleed during bowel movements, especially if there is straining involved. The blood from hemorrhoids is typically bright red and may be seen on the toilet paper or in the toilet bowl. Other symptoms of hemorrhoids can include itching, discomfort, or a feeling of fullness in the rectal area.

However, the fact that you are experiencing abdominal pain and difficulty urinating raises some additional concerns. Abdominal pain can be caused by a variety of issues, including gastrointestinal problems, urinary tract issues, or even more serious conditions. Difficulty urinating, particularly if it requires straining, could indicate a urinary tract infection or other urinary issues, which may or may not be related to your gastrointestinal symptoms.

While hemorrhoids are a common cause of rectal bleeding, it is crucial to rule out more serious conditions, including colon cancer, especially if you have a family history of colorectal cancer or if your symptoms persist or worsen. Colon cancer can present with rectal bleeding, changes in bowel habits, abdominal pain, and other gastrointestinal symptoms. It is important to note that while colon cancer is less common in younger individuals, it is not impossible, particularly if there are risk factors present.

Given your symptoms, it is highly advisable to seek medical attention promptly. A healthcare provider can perform a thorough evaluation, which may include a physical examination, a digital rectal exam, and possibly a colonoscopy to visualize the colon and rectum directly. A colonoscopy is a critical tool for diagnosing conditions like colon cancer, as it allows for the direct observation of the intestinal lining and the ability to take biopsies if necessary.

In summary, while your symptoms may suggest hemorrhoids, the presence of abdominal pain and difficulty urinating necessitates a comprehensive evaluation to rule out more serious conditions, including colon cancer. It is always better to err on the side of caution when it comes to symptoms like rectal bleeding, and seeking medical advice is the best course of action. Your healthcare provider will be able to guide you through the necessary tests and provide appropriate treatment based on the findings.

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