As the saying goes, “nine out of ten people have hemorrhoids”, many hemorrhoid patients are not surprised by the phenomenon of blood in the stool that occurs from time to time. In hospitals, we often hear that many patients find blood in the stool for a long time but think it is hemorrhoids and do not take it seriously, only to find out that it is rectal cancer. Hemorrhoids and rectal cancer are two very different diseases, so don’t be disgusted and look back at the color and nature of the stool after defecation, you are the first to notice the early subtle symptoms. Paying attention to the changes in stool, such as color, nature, frequency, etc., and having an understanding of your health status can help prevent problems before they occur. Blood in the stool is a symptom common to both rectal cancer and hemorrhoids, especially internal hemorrhoids, where the hemorrhoid itself is not visible on the body surface, making it a major factor affecting the differentiation between these two diseases. However, if you look at the characteristics of blood in stool of these two diseases, you can simply distinguish them as long as you are careful. Hemorrhoid blood in stool is usually bright red in color, while intestinal tumor bleeding is mostly dark red and contains mucus. Secondly, the shape of stool and bowel habits change. Hemorrhoids usually do not change stool habits and shape, while rectal cancer will have a change in bowel pattern and flattened or grooved stools. As mentioned above, hemorrhoids are varicose vein masses, so blood in the stool is mostly painless and intermittent, and sometimes there are lumps (vein masses) that prolapse from the anus. For prolapsed hemorrhoids, finger pressure is soft and, like veins in other parts of the body, can be squashed, or pushed back into the anus. If an internal hemorrhoid prolapses for a long period of time, it can become painful and hard, due to the formation of a blood clot within the varicose vein mass. As a solid tumor, rectal cancer is fixed in position and hard in texture, and usually does not appear to prolapse out of the anus. Because rectal cancer is fixed in the rectum, it will lead to stiffness and pressure on the rectal wall, resulting in more frequent stools, anal swelling, urgency and heaviness, and no or only a small amount of fecal discharge soon after defecation. Further growth of the tumor may also lead to narrowing of the rectal lumen or even partial blockage of the rectum, resulting in difficult stool and thin stool. A few patients may also suffer from abdominal pain and bloating due to rectal obstruction. Hemorrhoids, on the other hand, rarely cause these symptoms. When rectal cancer reaches advanced stage, it will also cause frequent urination, abdominal pain and pelvic pain due to tumor invasion of surrounding tissues and organs; anemia, weight loss and fatigue will occur when the tumor consumes the body for a long time. Most colorectal cancers originate from adenoma carcinoma, and more than half of adenomas larger than 2 cm will become cancerous. However, it may take several years or even longer from the occurrence of adenoma to cancer. If adenoma can be detected through colonoscopy and minimally invasive endoscopic treatment at the asymptomatic stage when adenoma is not cancerous or early cancerous, the chance of its transformation to cancer can be blocked.