There is a popular saying that “nine out of ten people have hemorrhoids”, so hemorrhoids are a relatively common disease, and for some patients who have suffered from hemorrhoids before, blood in the stool is often mistaken for a sign of recurrence of hemorrhoids. Blood in stool is most likely to confuse hemorrhoids and rectal cancer. The biggest similarity between rectal cancer and hemorrhoids symptoms is blood in stool, but if you can grasp some basic features of both, you can still distinguish clearly. First of all, the blood in stool of rectal cancer is persistent, chronic blood with mucus, dark red, usually mixed with feces, frequent bowel movements, and sometimes only some blood or mucus without feces is relieved. If the cancer tumor is farther away from the anus, the incidence of blood in the stool will be lower. About 80% of rectal cancers have blood in stool. However, hemorrhoid blood in stool is commonly bright red blood, not mixed with feces but attached to the surface of the fecal mass; it can also be manifested as dripping blood before and after stool, or in severe cases in the form of jets, mostly occurring when the stool is constipated. In addition, hemorrhoids do not cause difficulty in defecation, especially the thinning of the stool, and even if the nucleus of the hemorrhoid is prolapsed, it only shows a short-term reluctance to force to relieve the stool due to painful defecation, once the edema and inflammation subsides, it can immediately return to normal. In contrast, patients with rectal cancer can have difficulty in defecation, thin stool, abdominal distension, paroxysmal abdominal pain, and sometimes even feel the sound of bowel screaming. It is worth noting that the lumps in the body of rectal cancer patients often do not shrink, but only grow gradually and are cauliflower-like, light red and bleed easily when touched; while the lumps in hemorrhoid edema are often smooth, dark red or dark purple and bleed easily when touched. Finally, rectal cancer in late stage sometimes shows corresponding symptoms because the tumor invades the surrounding tissues, such as invasion of the bladder, which may cause frequent urination, violent and continuous pain when the presacral nerve is invaded, and if it moves to the liver, hepatomegaly, jaundice and anemia may appear, while hemorrhoids will not have these manifestations. We should not blindly worry that blood in stool must be cancer, and we should not let down our guard about blood in stool. You should still bring it to the regular hospital for consultation.