Hemorrhoids, an extremely common clinical rectal-anal disease, are mainly seen in adults and increase in incidence as we age. Because of this, many people with hemorrhoids don’t consider it as a “disease” anymore. However, experts say that hemorrhoids generally do not pose a serious health risk to the body, but their presence can easily lead to misdiagnosis of other diseases, for example, more than 90% of rectal cancer cases are misdiagnosed as hemorrhoids in the early stages. Experts remind that although hemorrhoids will not turn into rectal cancer, it is best for hemorrhoid patients to go to the hospital for rectal finger examination and proctoscopy in a timely manner. At the same time, it is also important to observe and feel yourself and do your own rectal examination, especially when the number of stools increases and there is a feeling of “urgency and heaviness”. Hemorrhoids: most likely to form after 6 months of pregnancy Regarding the cause of hemorrhoids, experts explain that when the venous pressure in the pelvic and perianal tissues is too high, it leads to blood stagnation and thrombosis in the rectal veins, which in turn causes the veins to dilate, thus forming hemorrhoids. All the factors that can block rectal venous reflux and lead to stagnation and dilatation of rectal veins can cause hemorrhoids, such as prolonged sitting and standing, as well as prostate enlargement and large pelvic tumors, among others. Also, diarrhea and constipation can cause tension in the abdominal muscles, increasing the venous pressure in the rectal canal, which over time can also lead to the formation of hemorrhoids. In addition, women during pregnancy, especially in the second six months of pregnancy, are most likely to form hemorrhoids because of the pressure that the enlarged uterus and the fetus in the uterus can put on the pelvic veins. The strong pressure that pushes the fetus out of the body when natural childbirth occurs can exacerbate the symptoms of hemorrhoids. This is why hemorrhoids are more prevalent in women. Of course, there are other factors such as the endocrine changes that women experience during menopause. Rectal cancer: More than 90% of cases are misdiagnosed as hemorrhoids in the early stages The clinical manifestation of hemorrhoids is fresh blood during stool or a lump coming out of the anus. Depending on where it occurs, there are external and internal hemorrhoids. Internal hemorrhoids occur in the anal canal, while those around the anus are external hemorrhoids, and some people have a mixture of both internal and external hemorrhoids. Internal hemorrhoids are mainly painless intermittent blood and prolapse of hemorrhoids after stool; external hemorrhoids are discomfort in the anus, easily moist and unclean, and if a thrombus or subcutaneous hematoma forms here, there is severe pain. It is worth noting that hemorrhoids generally do not pose a serious risk to the health of the organism, but their presence can easily cause misdiagnosis of other diseases, most notably rectal cancer. In recent years, many cases of rectal cancer were found in the clinic under the “cover” of hemorrhoids, and were not diagnosed until obvious obstructive symptoms occurred. This is related to the fact that many patients “do not consider hemorrhoids as a disease”. “The actual fact is that you will find a lot of people who think they are suffering from hemorrhoids, early on they like to purchase some topical creams from the pharmacy to self-govern. More than 90% of rectal cancer cases are misdiagnosed as hemorrhoids in the early stages.” Examination: rectal finger examination and proctoscopy is the king Rectal cancer is a malignant tumor with a high incidence in the gastrointestinal tract, and rectal cancer and hemorrhoids are two very different diseases in terms of etiology, pathology, treatment and prognosis, but why is there such a high rate of misdiagnosis? Doctors explain that some of this is self-misdiagnosis by patients and some is speculation by medical staff. “The main reason is that there are many similarities between the clinical manifestations of rectal cancer and hemorrhoids, such as blood in the stool and increased frequency of stools, resulting in rectal cancer being easily misdiagnosed as hemorrhoids in the early stage.” As long as patients are alert, early detection of rectal cancer is entirely possible, and the treatment effect of early rectal cancer is also very good. Of course, symptoms and stool tests alone are not enough to make a clear diagnosis. Rectal finger examination and proctoscopy are the way to go. Experts point out that hemorrhoids may occur in people of any age, while patients with rectal cancer are mostly middle-aged or elderly. Patients can also perform self-examinations through some simple methods. The first is self-observation and sensation. Patients with hemorrhoids have blood in their stool because they rub the affected area during defecation. Most of the blood drips down with the stool discharge, so the blood does not mix with the stool and there is no mucus present. In contrast, the stool of rectal cancer patients is often mixed with blood, mucus and thick liquid. In addition, the stool habit of rectal cancer patients will be significantly changed, and the frequency of stool will increase, and there will be a feeling of urgency and heaviness. In other words, there may be abdominal pain and embarrassment, the need to pass stool at times, and heavy anus, but there is no stool feeling after squatting or very little. In addition, patients with diarrhea should also pay special attention if the diarrhea does not decrease even after medication is administered. Next is rectal examination. Sticking a finger into the anus to check is one of the most effective methods. This is because most hemorrhoids and rectal cancers occur in areas that can be reached by the finger. If you feel some raised grains inside the anus with your finger, then you have hemorrhoids; if you feel a cauliflower lump or an ulcer with a raised edge and a sunken center, and you find that the intestinal cavity is so narrow that it can only accommodate a finger, and if there is blood, thick liquid and mucus on the finger sleeve after examination, then you are most likely to have rectal cancer, and you should go to the hospital as soon as possible to avoid missing the opportunity for treatment. Myth Clarification: Hemorrhoids generally do not transform into rectal cancer There are many people who will have doubts that even if both hemorrhoids and rectal cancer are lumps, will hemorrhoid lumps turn into rectal cancer? In fact, hemorrhoids and tumors are two diseases of different nature. Hemorrhoids, simply understood, are dilated and proliferated blood vessels and surrounding tissues under the skin at the anal verge, while tumors, are abnormal proliferative changes in the colorectal mucosa. To make a simple analogy: an enlarged hemorrhoid is like a watermelon with more and more flesh and bigger volume inside; while a tumor is a keloid that grows on the rind of the watermelon. One is a matter of flesh and the other is a matter of skin, two different things. Generally speaking, hemorrhoids do not transform into rectal cancer. Bowel polyps generally do not develop into bowel cancer but there are exceptions. When patients do colonoscopy or anal finger examination, sometimes colon polyps are also found, so will intestinal polyps also develop into intestinal cancer? Polyp and cancer are not the same thing, and the chance of polyp malignant change is generally relatively small. However, there is a kind of colon polyp, which is usually familial, and such patients inherited multiple polyps can turn into rectal cancer. In addition, polyps are chronic diseases and may become malignant due to mutation of polyp cells, however, the chance of this is not high. If polyps are found during colonoscopy, doctors will usually remove them, and if they are malignant when doing pathological biopsy, surgery will be required. 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