How to distinguish rectal cancer and hemorrhoids?

How to distinguish rectal cancer and hemorrhoids? The symptoms of rectal cancer and hemorrhoids are so similar, how to distinguish?

Hemorrhoids is the most common rectal benign disease, and it is also a common problem encountered by people at home and abroad. It often manifests as blood in the stool. Because the symptoms are very similar to rectal cancer. Clinically, about 90% of rectal cancers are misdiagnosed as hemorrhoids in the initial stage.

Because the symptoms are very similar to rectal cancer. Clinically, about 90% of rectal cancers are misdiagnosed as hemorrhoids in the initial stage.

Two major symptoms of hemorrhoids

Hemorrhoids are the expansion of the venous plexus under the mucous membrane of the rectum and under the skin of the anal canal, and the soft venous mass formed by varicose is divided into three types: internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids.

Hemorrhoids that occur above the dentate line and under the mucosa at the end of the rectum are called internal hemorrhoids; hemorrhoids that occur below the dental line are called external hemorrhoids; those that are present on and above the dental line are called mixed hemorrhoids.

The two most obvious symptoms of hemorrhoids are blood in the stool and prolapse of internal hemorrhoids. Most hemorrhoids do not require treatment. When symptoms such as prolapse of hemorrhoids, anal discomfort or swelling and pain occur, they really need treatment. The internal hemorrhoids protruding outside the anus are clamped by the sphincter, the venous return is blocked, and the arterial blood is still infused, the hemorrhoids increase in size, until the arterial blood vessels are compressed and thrombosis occurs, the hemorrhoids become hard, painful, and difficult to return In the anus, severely incarcerated hemorrhoids will form, which can cause necrosis and infection of the hemorrhoids. Therefore, when the internal hemorrhoids prolapse outside the anus after defecation, they should be returned to the anus in time to avoid serious complications such as prolapse and incarceration, or even accept it. The pain of surgery.

Hemorrhoids can occur at any age. The incidence of hemorrhoids is low in adolescents and increases with age. The incidence of hemorrhoids is 60%-70% for people over 50. The incidence of women due to pregnancy and childbirth is higher than that of men, but the rate of female visits is lower than that of men. Generally speaking, people who work for a long time, sit for a long time, and have little activity, such as taxis, car drivers, teachers, hairdressers, etc., have a higher incidence.

People who like to hold back their stools are more likely to develop hemorrhoids. Because of constipation or holding back stools, abdominal pressure will increase, rectal congestion, hemorrhoids, varicose veins, and even separation and prolapse of rectal mucosa and muscle layer, the anal canal moves down with the stool, and hemorrhoids are prone to occur over time. But hemorrhoids are not hereditary, nor can they become cancerous.

How to distinguish rectal cancer and hemorrhoids

Since hemorrhoids and rectal cancer have similar locations, the most common symptoms are blood in the stool. Therefore, when some symptoms overlap or are atypical, the clinical diagnosis is often confused. Especially when the two diseases coexist, after the examination finds hemorrhoids, the treatment is limited to hemorrhoids, which may delay the treatment of rectal cancer.

So, what is the difference between hemorrhoids and rectal cancer?

First, the characteristics of blood in the stool are different. Patients with hemorrhoids have blood in their stools, which are generally “passive” bleeding. This is because the stool scratches the affected area of ​​hemorrhoids during defecation. Most of the blood drips with the stool, so it does not mix with the stool, and there is no mucus. Therefore, it is usually blood on the surface of the stool, blood on the toilet paper after stool, and blood in the stool. The color is mostly bright red.

However, the bleeding of rectal cancer is “active” bleeding, because the surface of the tumor itself is ruptured, bleeding or oozing continuously. Since rectal cancer is often higher than internal hemorrhoids, when stool is stored in the rectum, it will be mixed with the bleeding from rectal cancer, resulting in mixed blood in the stool. Therefore, the stool with blood in rectal cancer is old bleeding, so the blood color is mostly dark red or jam-colored. At the same time, because rectal cancer destroys the rectal mucosa and produces mucus secretion, and secondary local infection discharges pus, the stool itself will also contain mucus and pus. The latter is also called pus and blood.

Secondly, hemorrhoids are varicose veins, so the blood is usually painless and intermittent, and sometimes lumps (vein masses) protrude from the anus. For prolapsed hemorrhoids, the fingers are very soft after pressing, and like veins in other parts of the body, they can be squashed or pushed back into the anus. If the internal hemorrhoids prolapse for a long time, there will be pain and induration due to the formation of blood clots in the varicose veins.

Rectal cancer is a solid tumor with a fixed location and a hard texture. It will cause stiffness and compression of the rectal wall, resulting in increased stool frequency, anal swelling, and bowel movements soon after defecation, but no stool or only a small amount of stool. If it grows further, it will cause the rectal lumen to become narrow or even partially block the rectum, resulting in difficulty in defecation and thinning of the stool. A small number of patients will also experience abdominal pain and bloating due to rectal obstruction.

In addition, rectal cancer also has changes in bowel habits. Because the secretions produced by the tumor can stimulate the intestines, causing frequent bowel movements, incomplete bowel movements and other symptoms, some patients will also experience symptoms such as long-term diarrhea, excessive farts, and a special foul smell.

Who do rectal cancer prefer?

Digital rectal examination is the simplest and most effective way to distinguish the two diseases. A preliminary diagnosis can be made by checking the mucosa around the rectum with fingers. Generally speaking, digital anal examination can detect more than 75% of rectal cancer, which is a common screening method.

However, limited by the length of the doctor’s fingers, the tumor on the upper rectum is often difficult to detect, and colonoscopy can be performed if necessary. Colonoscopy is to penetrate a thinner light microscope into the intestines, and transmit the conditions inside the intestines to the monitor, so that the doctor can find the tumor under direct vision with the naked eye and make a preliminary diagnosis of the nature of the tumor. While performing colonoscopy, tumor specimen sampling and biopsy can also be performed, and rectal cancer can be diagnosed through pathological examination. Colonoscopy can find almost all colorectal cancers, so it is called the “eye-catching eye” for colorectal cancer.

The following people must pay special attention to regular inspections to detect rectal cancer early:

1. People whose immediate family members have colorectal cancer patients:

Some of the colorectal cancer patients have a certain family genetic tendency, so genetic factors may play an important role. Among the immediate relatives who have had colorectal cancer, especially those who have had colorectal cancer for more than two consecutive generations, the risk of rectal cancer will increase significantly.

2. People who have suffered from bowel cancer:

Patients who have suffered from bowel cancer are several times more likely to develop rectal cancer again than ordinary people.

3. Patients with chronic colorectal diseases:

patients with familial adenomatous colorectal polyposis, long-term chronic ulcerative colitis, etc. Data show that nearly 80% of rectal cancers are transformed by adenomatous polyps ; The long-term stimulation of the rectum by chronic inflammation can also lead to malignant transformation, which eventually leads to the occurrence of rectal cancer.

4. Eating habits and other factors:

It is generally believed that people who consume a lot of high-calorie, high-fat, especially those who consume too much red meat, and those who eat too fine and low-fiber diets, will have a certain prevalence of rectal cancer. Increase; and living environment, lifestyle, work pressure, etc., will affect the incidence of rectal cancer.

(source:internet, reference only)

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