“Hemorrhoids are part of being human and play an important role in continence,” says Kinga Skowron Olortegui, MD, a colorectal surgeon and assistant professor at UChicago Medicine. “The problem is when they act out, but it’s often the pushing or straining due to constipation that makes them swell. So treating the constipation with a fiber supplement is one of the most effective treatments.” But some symptoms of hemorrhoids, like rectal bleeding, where you may find bright red blood on your toilet paper or see blood in the toilet after a bowel movement, may also be caused by other diseases, some of them serious, like colon cancer. So how, then, do you know when to see a doctor? “If patients have pain or bleeding after their bowel movements have normalized, they should have it checked by a doctor,” says Dr. Olortegui.
Colon Cancer, Rectal, or Anal Cancer “If there’s bleeding or a bump that’s growing, we want check for cancer,” says Olortegui. It’s a growing concern, especially since colon cancer rates are rising in people under 50, according to a March 2020 study published in CA: A Cancer Journal for Clinicians. These cancers can occur near the rectum and cause bleeding and discomfort that are similar to hemorrhoid symptoms. Colon cancer symptoms may include persistent bleeding, a change in bowel habits or bowel movement shape, lower abdominal pain, and unexpected weight loss. Anal cancer is much less common than colon or rectal cancer. Signs of anal cancer include bleeding around the anus, a growing lump, pain in that area, or discharge. If any of those symptoms are prevalent, you should speak to your doctor.Inflammatory Bowel Disease (IBD) This condition, which includes ulcerative colitis and Crohn’s disease, can cause rectal bleeding and discomfort. Both types of IBD are long-term diseases where the sphincter may become inflamed, producing symptoms similar to hemorrhoids. Other symptoms of IBD may include cramps, diarrhea, weight loss, and fever. Keep in mind that people with IBD also have hemorrhoids because of their abnormal bowel habits.Anal Fissures “Anal fissures are small tears, like paper cuts, in the anal canal that can act very much like hemorrhoids,” says John Hall, MD, a colorectal surgeon and surgeon in chief and chairman of the department of surgery at Tufts Medical Center in Boston. Anal fissures can cause pain, burning, and bleeding. They can occur at any age and, like hemorrhoids, are usually caused by constipation. They usually clear up with home treatments similar to those used for hemorrhoids. However, if the bleeding doesn’t clear or if its accompanied by a growing lump, talk to your doctor.Perirectal Abscess The abscess is a pus-filled bump found near your anus or rectum and can occur when one of your anal glands gets clogged and infected. Symptoms like pain and being uncomfortable can mimic hemorrhoids, but abscesses tend to be more painful, constantly throbbing, and larger than a hemorrhoid.Pruritis Ani “Also known as anal itching, it’s easily mistaken for hemorrhoids, but it’s just an itch that often clears up with some dietary changes,” explains Olortegui. “It’s often triggered by spicy or acidic foods.” Pruritis ani causes an intense urge to scratch. It may result from too much moisture or a food sensitivity. Treatment involves keeping the area dry, avoiding scrubbing, and using a prescription ointment or cream.Pinworms Commonly found in children, pinworms are tiny parasites that hatch in the small intestine, then move on to live in the large intestine for about one or two months. The female worms then leave the body to lay their eggs on the skin surrounding the anus. While most people with a pinworm infection generally don’t exhibit symptoms, those who do experience anal itching, a symptom similar to hemorrhoids.Anal Warts Similar to genital warts, one of the many sexually transmitted diseases (STDs) that can grow in the anal area and cause symptoms of bleeding and discomfort. Anal warts and genital warts are caused by human papilloma virus (HPV), and they should always be treated because they will continue to grow and increase the chances of getting anal cancer.
Getting Help for Hemorrhoid Symptoms
You should seek treatment for hemorrhoid symptoms if:
You have rectal bleeding for the first time.You have heavy rectal bleeding.You have rectal bleeding that is not responding to home care.You see blood in your stool.You have other hemorrhoid symptoms, such as pain, pressure, itching, and burning, that do not respond to home care after a few days.You have hemorrhoid symptoms along with other symptoms such as fever, weight loss, abdominal pain, or a change in bowel habits.You have a bump that seems to be growing.You have continued pain after bowel movements are normal again
“If there’s bleeding, we’re going to do a colonoscopy to rule out some dangerous conditions,” says Olortegui. “If we can rule out cancers, then we evaluate the condition with an anoscopy [a short tube used to examine the anal area] to give us a clear picture of the rectum and anal canal. That way we can make sure the hemorrhoids look okay or we can determine if surgical intervention is warranted.” Additional reporting by Jordan M. Davidson.
