This day, as soon as Ms. Zhang entered the clinic, she asked me with a nervous look on her face: “Dr. Zhu, do I have intestinal cancer? I said don’t panic, and then asked about her condition: Ms. Zhang is a company employee, 38 years old, 6 years ago after pregnancy and childbirth, she had blood in the stool, which was diagnosed as internal hemorrhoids at that time, and after using medicine, she improved and did not have blood in the stool again. This morning, she woke up and found blood in the toilet bowl. She remembered that she had read on the Internet that bleeding in the stool is a sign of intestinal cancer, so she was very afraid and took leave from work to come to the hospital. After examination, I found that she had mixed hemorrhoids. I examined her and found that it was a mixed hemorrhoid. I gave her some medicine and advised her to stop eating spicy food and drinking alcohol, to rest more and not to get tired, and to come back for a follow-up appointment in two weeks, and she was happy to tell me that there was no more bleeding. Although both hemorrhoids and rectal cancer can manifest as blood in the stool, how do you know whether you have hemorrhoids or bowel cancer? Although there is this most obvious common point between the two, there are still some minor differences most of the time. Here I can give you a few clues for general reference: 1. Most of the bleeding from hemorrhoids has some triggering factors, such as drinking alcohol, eating spicy and other irritating foods, fatigue after physical activities, etc. In contrast, rectal cancer bleeding basically does not have these triggers. 2. In terms of age of onset, hemorrhoids can occur in young or old people, while rectal cancer is mostly seen in middle-aged and old people. Therefore, middle-aged and elderly people should be more alert when blood in stool occurs. (But this does not mean that young people will not necessarily get rectal cancer, I see several cases of rectal cancer patients in their 30s every year.) 3, from the symptoms, most hemorrhoids are “painless blood in the stool”, sometimes there is pain, most often combined with anal fissures, or external hemorrhoids edema. In contrast, in addition to blood in the stool, rectal cancer often has “changes in bowel habits or traits”, such as an increase in the number of stools, straining to defecate, a sense of incomplete defecation, unshaped stools, or thinning, etc. 4. Patients with family history of malignant tumors, especially gastrointestinal tumors, are more likely to get rectal cancer than those without family history. Understanding the above-mentioned differences can help you determine which one is more likely, but there are no absolutes, as rectal cancer can sometimes have no “change in bowel habits or traits” and needs to be clearly diagnosed through colonoscopy. Moreover, even if it is hemorrhoids, if left untreated, the aggravation of symptoms can affect work life. Therefore, no matter what age you are, if you find bleeding in your stool, don’t diagnose yourself randomly based on specious information, it is recommended to go to the hospital in time.