Common symptoms like rectal bleeding and pain may lead you to believe you have hemorrhoids, but they might actually be indicators of more serious illnesses, such as colon cancer. For this reason, it is important to recognize the symptoms and seek medical advice when they appear.

Dr. Jennifer Ayscue, Chief of Colorectal Surgery for the West Region at Orlando Health Bayfront Hospital, and Dr. J. Ryan Williams, are experts in the field of colorectal healthcare. Both understand the sensitive nature of their patients’ conditions and take extra care to help them feel comfortable discussing their symptoms and their diagnosis, whether it’s hemorrhoid or cancer, or some other problem. Personalized treatment plans and comprehensive medical consultations are hallmarks of their care.

Common causes  of rectal bleeding, swelling, and pain

The presence of rectal bleeding, swelling, or pain should prompt immediate medical attention, because it can be a precursor to more serious complications. In addition to the more well-known reasons like a hemorrhoid or cancer, other possible causes include anal fissures, diverticular disease, or inflammatory bowel disease. To identify the root cause and get the right treatment, a medical examination is necessary.

Detailed overview of common conditions

• Itching, discomfort, painful lumps, and the presence of bright red blood in the stool are signs of hemorrhoids, which are swollen veins in the rectum or anus. Seek medical attention if symptoms continue or get worse. Hemorrhoids typically develop as a result of increased pressure in the anal area from things like straining or sitting for lengthy periods of time.
• Colorectal cancer. Unusual weight loss, changes in bowel habits that don’t go away, and dark-colored stool are some of the key indicators of colorectal cancer. It is important to seek medical attention if you encounter these symptoms, because early discovery is key to successful treatment.
• Anal fissures. Small rips in the anus lining, known as anal fissures, might develop as a result of straining, constipation, or passing firm stools. Pain during or after defecation, excessive bleeding, and the presence of outward signs of anus cracks or lumps are all symptoms.
• Proctitis (inflammation of the rectum). Inflammation of the rectal lining causes proctitis symptoms such as rectal pain, bleeding, diarrhea, and an overwhelming need to defecate. Some common causes include sexually transmitted infections (STIs), such as chlamydia and gonorrhea, inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease, and cancer radiation treatment.
• Rectal abscesses and fistulas. When anal glands get infected, it can lead to painful swellings called rectal abscesses. These lesions can drain pus, blood, or excrement.
• Inflammatory bowel disease (IBD) – ulcerative colitis and Crohn’s disease. IBD, which includes ulcerative colitis and Crohn’s disease, is chronic inflammation in the gastrointestinal system. Symptoms include abdominal discomfort, diarrhea, and rectal bleeding. Ulcerative colitis mostly affects the large intestine and rectum, while Crohn’s disease can affect any portion of the GI tract. Because of its direct effect on the colon and rectum, ulcerative colitis is more frequently linked with rectal discomfort and bleeding, although both illnesses can induce these symptoms.
• Diverticular disease. People sometimes develop a pouch-like structure or bulge, called diverticulum, on the wall of the colon. This is called diverticulosis. If these bulges get inflamed, that’s called diverticulitis. It can cause pain, nausea, fever, a tender abdomen, and changes in the stool. It also can lead to severe consequences, including abscesses, obstruction, and internal bleeding.

When to seek medical evaluation

As we have seen, a wide range of illnesses can cause symptoms related to the bowels. If you experience mild symptoms, it’s natural to try over-the-counter remedies. But if you have intense systems, a combination of symptoms, and/or symptoms that don’t go away, it is important to get a professional health assessment right away. Instead of trying to guess what’s wrong or relying on over-the-counter medications for pain relief, it’s best to see a doctor for a proper diagnosis and medical advice. Colon cancer awareness might save your life.

Diagnostic approaches

Diagnostic tools are vital for differentiating between various rectum and colon disorders. In addition to spotting typical problems like hemorrhoids, a thorough physical exam can flag abnormal growths that may necessitate more testing, including a possible biopsy, if needed.

During a colonoscopy, a flexible tube with a tiny camera and light is inserted into the rectum while the patient is sedated. This permits a thorough examination of the colon to detect abnormal growths or cancer.

A sigmoidoscopy is a similar procedure that looks at the sigmoid colon, the lowest part of the colon before it leads to the rectum and anus. If a growth is found during either of these two scoping procedures, the doctor typically does a biopsy or completely removes the lesion to see if the growth is cancerous.

Imaging studies , such as CT scans, also may be used to help determine the kind and degree of abnormalities.

Treatment options

• Hemorrhoids. Increasing fiber intake, avoiding constipation and spending too much time on the toilet, increasing physical activity, and using natural remedies like a sitz bath to alleviate pain.
• Colorectal cancer. Surgical removal of malignant tumors, chemotherapy or radiation therapy, medication to reduce or halt the progression of cancer, and treatments that address both the disease and its treatment-related complications.
• Anal fissures. Externally applied medications, topical anesthetic creams, Botox injections, blood pressure medicines, and surgery (if other treatments fail).
• Proctitis (inflammation of the rectum). Dietary adjustments, antibiotics (if caused by an infection), injury management (if caused by trauma), and medications for radiation effect or IBD.
• Rectal abscesses and fistulas. Surgical drainage, antibiotics, fistulotomy (the fistula tract is opened to allow healing from the bottom up), and advanced surgical techniques for complex fistulas.
• Inflammatory bowel disease (IBD) – ulcerative colitis and Crohn’s disease. Medication to suppress the immune system’s abnormal inflammatory response, combination therapy (adding a biologic to an immunomodulator), clinical trials, adjusting diet, and surgery.
• Diverticular disease. Dietary, nutrition, and lifestyle adjustments, medication (if an infection is present), hospitalization and IV antibiotics (for more serious complications), and surgery. Follow-up care may require a colonoscopy six weeks after symptoms go away.

How to tell if it’s a hemorrhoid or cancer?

Rectal symptoms can originate from a variety of illnesses, like a hemorrhoid or cancer, that call for different types of prevention and treatment. Before you can determine the right treatment and manage symptoms, you need an accurate diagnosis. Ongoing medical research continues to improve our understanding of these conditions, leading to better prevention strategies and treatment options.

Florida Medical Clinic Orlando Health offers best-in-class clinical care, including diagnostic and treatment options found only at the most advanced digestive health centers. Our colon and rectal surgeons work closely with your primary care physicians and other specialists, sharing test results and treatment plans instantaneously through our electronic health records system.

Meet Our Colon and Rectal Surgeons

Dr. Ayscue

Jennifer Ayscue, MD is the Chief of Colon and Rectal surgery for the west region at Orlando Health Bayfront Hospital. A colorectal surgeon for more than 20 years, she most recently served as the Vice Chief of Quality, Safety and Outcomes for the Department Surgery at a northeastern healthcare system.

Dr. Ayscue is a fellow of the American College of Surgeons and American Society of Colon and Rectal Surgeons, where she serves on national committees. She is also a member of the editorial board for the Journal of Surgical Oncology and has been published in several other medical journals. In addition, Dr. Ayscue serves on national committees for rectal cancer, colorectal surgery guidelines, and pelvic floor disorders.  Dr. Ayscue specializes in anorectal disorders, fecal incontinence, and minimally invasive techniques for rectal prolapse, cancer, IBD and other colorectal diseases.

Dr. Williams

 J. Ryan Williams, MD is a board-certified colon and rectal surgeon with Florida Medical Clinic Orlando Health. In addition to his expertise in the specialized care of colon and rectal conditions, he is certified as a console surgeon on da Vinci® Robotic Surgical Systems and performs complex laparoscopic and minimally invasive surgeries.

He was listed in Tampa Magazine as one of the area’s Top Doctors for Colon and Rectal Surgery. Dr. Williams is active in the American Society of Colon and Rectal Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, and American College of Surgeons, where he serves on multiple committees nationally.

Call today at 727-893-6363 to make an appointment with Dr. Ayscue and Dr. Williams.