Hemorrhoids vs Colorectal Cancer: Signs, Treatment, and Complications

Medically reviewed by: Gary H. Hoffman, MD

Did you know that there are two very different diseases that can affect your rectum and anus? Hemorrhoids and colorectal cancer are both common, but they have very different symptoms, treatments, and complications. In this article, we will compare and contrast these two diseases to help you understand the differences between them.

What are Hemorrhoids?

Hemorrhoids — also called piles — are swollen veins in the anal canal. They can be either internal, which means they are inside the rectum, or external, which means they are outside the anus. Hemorrhoids are common, and most people will experience them at some point in their lives.

They often occur after straining during a bowel movement, pregnancy, or due to obesity (but there are other causes too). Fortunately, most hemorrhoids usually resolve on their own, especially if they are small. But they can sometimes become irritated and bleed significantly, and this bleeding might lead some people to confuse them with colorectal cancer.

What is Colorectal Cancer?

Colorectal cancer is a type of cancer that affects the colon and rectum (the last parts of your large intestine). It is the third most common type of cancer in the United States (after lung and breast/prostate cancer).

Unlike hemorrhoids, colorectal cancer usually develops slowly over time, and it is most common in people over the age of 50. However, it can occur at any age. It has been noted that younger people are now being diagnosed with colorectal cancer.

Symptoms of colorectal cancer depend on the part of the GI tract it involves. For example, left-sided colorectal cancer classically causes a reduction in stool diameter, while right-sided cancers cause bleeding and anemia (an abnormally low hemoglobin level). Keep in mind that hemorrhoids can also cause iron-deficiency anemia if they bleed significantly.   Many cancers are asymptomatic however, being discovered during a routine colonoscopy, or during a colonoscopy in patients with a “GI upset”.

How are Hemorrhoids and Colorectal Cancer Different?

There are several key ways in which hemorrhoids and colorectal cancer are different.

First, hemorrhoids are rarely serious and almost never life-threatening, while colorectal cancer can be fatal.

Second, symptomatic hemorrhoids usually stop causing symptoms  on their own, while colorectal cancer requires treatment. This means if your rectal bleeding has persisted for years, you might have colorectal cancer (and not hemorrhoids).

Third, the symptoms of hemorrhoids and colorectal cancer are different. Hemorrhoids often cause itching, pain, and bleeding, while colorectal cancer may cause bleeding, abdominal pain, and weight loss.

Fourth, the risk factors for hemorrhoids and colorectal cancer are different. As we mentioned before, hemorrhoids are often caused by straining during a bowel movement, pregnancy, or obesity.

Colorectal cancer, on the other hand, is often caused by a combination of lifestyle and genetic factors. For example, people who eat a lot of red meat or processed foods, smoke cigarettes, or have a family history of colorectal cancer are at an increased risk for the disease.

Then, the complications of hemorrhoids and colorectal cancer are also different. Hemorrhoids can sometimes become irritated and bleed, but they almost never lead to more serious problems.

On the other hand, colorectal cancer can metastasize, or spread to other parts of the body, which can be life-threatening. The most common location for colorectal cancer to metastasize is the liver. When this happens, patients can experience a wide range of problems, including jaundice (yellowing of the skin), fatigue, significant weight loss, and bleeding problems.

Finally, the treatments for hemorrhoids and colorectal cancer are different. Hemorrhoids can often be treated at home with over-the-counter creams and ointments. If these don’t work, your doctor may recommend a procedure to treat or remove the hemorrhoids.

Colorectal cancer, on the other hand, may require a combination of treatments including surgery, chemotherapy and/or radiation therapy. The specific treatment depends on the stage of the cancer.

How are hemorrhoids diagnosed?

Hemorrhoids are usually diagnosed based on your symptoms. Your doctor will ask you about your medical history and do a physical examination to identify hemorrhoids. They may also order a stool sample to rule out other causes of your symptoms, such as an infection or cancer.

In some cases, your doctor may recommend a procedure called a sigmoidoscopy or colonoscopy. This involves inserting a long, flexible tube into your rectum and colon to look for anything that might be causing your rectal bleeding.

How is Colorectal Cancer Diagnosed?

In contrast to hemorrhoids, colorectal cancer is usually diagnosed with a combination of tests, including a physical examination, stool sample, blood test, sigmoidoscopy or colonoscopy, and imaging tests.

Your doctor will likely order a colonoscopy, which is the most effective way to diagnose colorectal cancer. This procedure involves inserting a long, flexible tube into your rectum and colon to look for abnormal growths. If any are found, your doctor will take a biopsy, or small sample of tissue, to be examined for cancer.

Imaging tests, such as a CT scan or MRI, may also be used during colorectal cancer workup. These tests can help your doctor determine the size of the tumor and if it has spread to other parts of the body.

Can Hemorrhoids Cause Cancer?

Although haemorrhoids can’t directly cause cancer, they can lead to long-term inflammation around the anal area. This is especially true if you’ve had many hemorrhoid treatments over the years.

There is no known association between hemorrhoids and colorectal cancer.

Now you Know the Difference Between Hemorrhoids and Colorectal Cancer!

While hemorrhoids and colorectal cancer share some similarities, they are two very different conditions.

Hemorrhoids are usually not serious and can be treated at home, while colorectal cancer is a potentially life-threatening disease that requires treatment with surgery, radiation therapy, and/or chemotherapy.

If you have any concerns about your symptoms, be sure to see your doctor for a proper diagnosis.