Could I have colon cancer if I have a history of piles and blood on passing motion?

Hi

Piles is a very common condition and especially in modern society with our current life style. They don't normally cause difficulty blockage but the problems comes if you are constipated and the stools are hard.

To improve on this, the general advise is ensure that you have adequate amount of fluids daily (>2L) and a good amount fruit and vegtables daily for the fibre. This will ensure you are regular and the stools are soft to prevent the straining and constipation that will agravate the piles. Laxative may help to keep the stools soft.

The blood that you pass from piles (due to hard stools and constipation) is generally due to the surface of the piles being scratched or traumatised by the stools. This is very alarming but if it is coming from the piles, then rest assure that there is nothing to worry about.

The blood generally should be bright red blood as oppose to your deep red blood. This may suggest that it can be coming from higher up in your colon and not your piles. Either way, it is very important that you have it check out by getting your colon looked at and to see where the bleeding is coming from by way a simple procedure called colonoscopy.

Colonoscopy is a test which passes a flexible camera up your colon from below and it looks directly into the colon and e=it examines the lining of the colon. It will be done as a day-case where you just go into hospital to have it performed and then you will discharged a few hours later. If it is just your piles then that can be treated easily depending on how big your piles are. If there is any other lesions seen during the procedure such as polyps, it can be removed at the same time. For other larger lesions, a biopsy can be taken. It is still very important to check where the bleeding is coming from and definitely to exclude the possibility of colon cancer as the cause of your bleeding.

Thanks for your question.

Some risk factors of colon cancer are as follows:

1. Age > 50
2. Family history of cancer/colon cancer
3. Smoker
4. Obesity

If you have any of these, then it’s definitely worthwhile going to see your doctor to have it checked out.

He can easily risk stratify you from your history, do a rectal exam to check where the bleeding is coming from, and if necessary refer you on for a colonoscopy test. You can read more about colonoscopies in Singapore here.

Since you are worried about colon cancer in particular, some other warning signs include:

• A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks
• Persistent abdominal discomfort, such as cramps, gas or pain
• A feeling that your bowel doesn’t empty completely
• Weakness or fatigue
• Unexplained weight loss

If you are a young guy however, with none of the warning signs or risk factors, the bleeding you described is most likely fresh blood due to your piles and hard stools/constipation.

You probably should tell your doctor that your previous laxatives didn’t work so well (he can give you other types), and should also introduce more fibre into your diet. That will help both your piles, constipation, and bleeding.

Detecting blood of any forms in your stools is a significant finding that one should never take lightly. The forms that blood can appear ranges from fresh red, deep maroon to tarry black. In general, the brighter the colour of the bloodstains, the nearer the source of bleeding from your anus.

The causes of bleeding in our lower digestive tract include infections, piles (haemorrhoids), minor anal tears (anal fissure), bleeding polyps as well as colon cancer. Having any one of the above problems in the past does not provide immunity to developing other problems. In fact, many people have more than one reason for blood in their stools.

So if you discover blood in your stools the next time, please do not assume it is from your piles. Please remember early detection always ensures a better prognosis for colon cancer.

• Dr Quan

Bleeding from piles is very common and can happen to anyone. Many patients who have colorectal cancer assume that when they see blood in the stools, it is because they have piles. If you see blood in your stools, you should consult your doctor to see if further tests are warranted.