Difference between hemorrhoids bleeding and rectal cancer bleeding

Written by Zhang Peng
General Surgery
Updated on April 18, 2025
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The difference between bleeding from hemorrhoids and rectal cancer is distinct. For hemorrhoids, bleeding is mostly painless and intermittent, primarily manifesting as bright red blood either dripping or spraying into the toilet bowl. Patients may even experience significant blood loss, potentially leading to shock.

On the other hand, bleeding from rectal cancer usually involves blood mixed with stool and generally does not involve large volumes. Most patients present with dark-edged stool. Anemia is often detected during routine blood tests, which leads to further investigation with a colonoscopy that may reveal rectal cancer. Therefore, the bleeding characteristics of the two conditions are different. In cases where rectal cancer is suspected, proactive endoscopic examinations are recommended to confirm the diagnosis through tissue pathology, followed by aggressive surgical treatment.

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How long can one live after rectal cancer surgery?

The specific life expectancy after radical resection for rectal cancer varies among individuals and is dependent on various factors including the patient's general and physical condition, pathological staging post-surgery, and whether there are high-risk factors for recurrence such as lymph node metastasis, vascular tumor thrombus, and nerve invasion. The overall five-year survival rate post-surgery is approximately 50%. If the disease is confined to the submucosa and lacks high-risk factors such as vascular tumor thrombus, nerve invasion, or lymph node metastasis, the five-year survival rate after radical surgery can reach up to 90%. However, if post-surgery pathology reveals lymph node metastasis, vascular tumor thrombus, and nerve invasion, among other high-risk factors, the patient's five-year survival rate will decrease. Thus, survival rates are closely related to many factors.

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How to rule out the possibility of rectal cancer

Common symptoms of rectal cancer include abdominal pain, changes in stool characteristics, and rectal bleeding. These symptoms could suggest the possibility of rectal cancer. An initial examination can be conducted via a digital rectal exam to preliminarily exclude rectal cancer. If a mass is felt during the digital rectal exam, a high suspicion of rectal cancer should be maintained. Additionally, a colonoscopy can be performed for a definitive diagnosis. If a mass on the rectal mucosa is observed during the colonoscopy, a biopsy can be conducted for histopathological examination to determine the nature of the mass. Generally, if the surface of the mass is uneven, brittle, and bleeds easily, the likelihood of malignancy is high while a smooth surface suggests a greater possibility of benignity.

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What are the late-stage symptoms of rectal cancer?

The late-stage symptoms of rectal cancer patients in clinical practice mainly include the following types. The first type is abdominal symptoms caused locally by rectal cancer. For example: bloody stools, pass stools with mucous and pus, anal pain, bloating, abdominal pain, and other manifestations. The second category of symptoms is those from metastases in various locations. For example, bone metastases cause bone pain and limb movement disorders. Lung metastases cause chest tightness, shortness of breath after activity, chest pain, breathing difficulties, coughing and coughing up blood, etc. Brain metastases cause headaches, dizziness, and seizures. The third category of symptoms is mainly systemic symptoms caused by rectal cancer lesions, such as: weight loss, fatigue, and high fever.

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Postoperative Diet and Care for Rectal Cancer

Firstly, rectal cancer is a malignant tumor of the digestive tract, so after surgery, it is recommended to eat foods that are easy to digest and absorb. Secondly, do not smoke, abstain from alcohol, and avoid spicy and irritating foods. Thirdly, it is advised not to eat indigestible foods, such as bean products and foods that cause gas, and to consume them in smaller quantities. Fourthly, rectal cancer may deplete a large amount of nutrients in the body, coupled with the damage from surgery, so it is essential to ensure a nutrition-rich diet, consume nutritious foods such as soups, easily digestible congee, and high-quality proteins to increase the body's nutrients. Fifthly, attention should be paid to timely adding clothing to avoid catching a cold.

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How to detect colorectal cancer early

In clinical practice, to detect colorectal cancer early, screening should be prioritized for individuals with a family history of colorectal cancer. This generally involves tests for tumor markers and colonoscopy examinations. The tumor markers include carcinoembryonic antigen, carbohydrate antigen 724, carbohydrate antigen 199, and carbohydrate antigen 125, among others. Colonoscopy examinations should be conducted annually. Furthermore, for individuals with colorectal polyps, yearly colonoscopy is especially recommended to detect early stages of colon cancer. Similarly, for individuals suffering from chronic inflammatory diseases of the colon and rectum such as ulcerative colitis or Crohn's disease, colonoscopy examinations should also be performed to facilitate early detection of colorectal cancer.