You’re finishing up a bathroom visit when you notice blood on the toilet paper. It’s easy to feel uneasy and start thinking about the worst-case scenario. Many people assume it’s just piles, also known as haemorrhoids, but the uncertainty can be unsettling, especially if this keeps happening.
To help ease your mind, colorectal surgeon Dr Ho Kok Sun explains the differences between piles and colorectal cancer, clears up common misconceptions, and shows why accurate diagnosis matters. Keep reading to understand what your symptoms could really mean.
Piles vs Colon Cancer: Understanding the Difference
While piles and colon cancer are separate conditions, they sometimes share similar symptoms, including bleeding and discomfort. Recognising the differences can help you know when to seek medical advice.
Piles (Haemorrhoids)
Piles occur when veins in the rectal or anal area become swollen, often due to straining during bowel movements, constipation, or pregnancy. Bleeding from piles is usually bright red and may appear on toilet paper or in the toilet bowl. External piles or thrombosed haemorrhoids can cause pain, swelling, itching, or lumps around the anus.
Colon Cancer
Colon cancer arises from uncontrolled growth of abnormal cells in the colon or rectum. Bleeding may be darker in colour, sometimes mixed with stool or mucus. Other warning signs include unexplained weight loss, fatigue, and persistent changes in bowel habits such as diarrhoea, constipation, or narrower stools.
Do Piles Increase the Risk of Colon Cancer?
Most research indicates that piles and colon cancer develop independently and are caused by different factors. Piles result from increased pressure in rectal veins, whereas colon cancer is linked to the abnormal growth of cells.
However, a 2021 study published in the Journal of Clinical Medicine (PMC) noted a possible association. The study reviewed thousands of medical records over ten years and found that individuals with haemorrhoids were 2.39 times more likely to develop colorectal cancer. The exact reason for this link is unclear. It may be that piles prompt medical attention that leads to earlier detection of colorectal cancer, or that another underlying factor contributes to both conditions.
Because of this uncertainty, any persistent bleeding or changes in bowel habits should be checked by a colorectal specialist. Early evaluation helps ensure that more serious conditions are not overlooked.
Why Accurate Diagnosis Is Essential
Rectal bleeding is a common reason people visit a doctor. While piles are often the cause, assuming bleeding is always due to haemorrhoids can delay the diagnosis of more serious conditions such as colorectal cancer.
According to Dr Ho Kok Sun, early and accurate diagnosis is key to effective management. He recommends a thorough medical evaluation if you experience:
- Persistent or heavy rectal bleeding
- Dark or tarry stools
- Unexplained weight loss or fatigue
- Changes in bowel habits lasting more than two weeks
Diagnostic Tests for Rectal Bleeding
If bleeding or other symptoms continue, your doctor may suggest tests to determine the underlying cause. These assessments help differentiate between piles and more serious conditions.
Digital Rectal Examination (DRE)
This initial examination involves the doctor gently inserting a gloved, lubricated finger into the rectum to check for swelling, lumps, or irregularities. Despite its simplicity, this test provides useful information about the rectal wall and surrounding tissue.
Colonoscopy
A colonoscopy uses a thin, flexible tube with a camera to inspect the colon and rectum. This test allows doctors to identify abnormalities such as polyps, growths, or early signs of cancer, and is considered one of the most accurate diagnostic tools.
Biopsy
If unusual tissue or growths are found during a colonoscopy, a small sample may be taken for laboratory analysis. This helps determine whether the tissue is benign, precancerous, or cancerous, guiding appropriate treatment planning.
While piles do not directly cause colon cancer, they can mask symptoms, making early detection more challenging if bleeding is assumed to be from haemorrhoids. At HKS Piles Clinic, Dr Ho Kok Sun offers thorough diagnostic evaluations and personalised treatment plans to ensure accurate diagnosis and effective management. Contact us to schedule a consultation.
About Dr Ho Kok Sun
Dr Ho Kok Sun
Consultant Colorectal and General Surgeon
MBBS (Singapore), M Med (General Surgery) (Singapore)
FRCS (General Surgery) (Edinburgh), FAM (Singapore)
Dr Ho Kok Sun has dedicated more than a decade to the management of piles and haemorrhoids, offering both surgical and non-surgical treatment options. He is the past President of the ASEAN Society of Colorectal Surgeons and the Society of Colorectal Surgeons (Singapore), and a founding member of the Eurasian Colorectal Technologies Association.
Beyond clinical practice, Dr Ho has been actively involved in training medical students and residents and has contributed extensively to medical literature through journal publications and book chapters. He believes that every patient’s treatment should be individualised, focusing on safety, comfort and long-term results.
