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Dr QM Leong
Dr QM Leong

Is It Anal Fissures Or Colon Cancer? Learn What Blood In Your Stool Means

Discovering blood in your stool can be a distressing experience. It’s a symptom that understandably triggers concern, often leading to a flurry of questions about its cause. Could it be an anal fissure or colon cancer? And should you be alarmed? 

When comparing Anal Fissure vs Colon Cancer, there is going to be a lot of overlap between symptoms. Despite these superficial signs, they differ in nature, severity, and treatment. 

This article aims to differentiate anal fissure and colon cancer and, most importantly, to emphasise the necessity of proper diagnosis for an effective treatment plan.

Blood In Stool: A Common Symptom For Anal Fissure And Colon Cancer

The confusion between anal fissures and colon cancer primarily stems from overlapping symptoms, particularly rectal bleeding.

Both conditions can present with this symptom, but the nature and appearance of the blood and other accompanying symptoms differ, leading to self-diagnosis confusion.

In anal fissures, the blood is typically bright red and appears on the surface of the stool or toilet paper, indicating its source is near the anal area. 

In colon cancer, the blood can be darker and mixed within the stool or may cause the stool to appear black and tarry, suggesting a higher source in the digestive tract.

In addition to blood in stool, the nature of other symptoms for both anal fissures and colon can also confuse. To identify which condition you may have, you need to know what these conditions are, their symptoms, causes, and risk factors.

What Are Anal Fissures?

An anal fissure is a small tear in the thin, moist tissue lining the anus. This condition is more common than you think and can cause considerable discomfort. Both men and women may develop this condition.

Symptoms Of Anal Fissures

  • Sharp, tearing or burning sensation during bowel movements
  • Small amounts of blood in stool that’s usually bright red in colour
  • Persistent itching or irritation around the anal area.
  • A visible tear or cut in the skin around the anus.

Causes Of Anal Fissures

  • Straining During Bowel Movements: Often due to constipation, leading to excessive pressure and tearing.
  • Passing Hard or Large Stools: Can cause direct trauma to the anal canal.
  • Chronic Diarrhoea: Repeated irritation and inflammation in the anal area.
  • Childbirth: This is especially common in women post-delivery due to the pressure and strain during childbirth.

Risk Factors

  • Age: More common in young adults and infants, though they can occur at any age.
  • Recent Childbirth: Women are at higher risk postpartum.
  • Crohn’s Disease or Inflammatory Bowel Disease: Conditions that cause inflammation of the bowel can lead to an increased risk of anal fissures.
  • Anal Intercourse: This can cause physical trauma to the anal area.
  • Previous Anal Surgeries: Past surgeries can lead to increased susceptibility.

What Is Colon Cancer?

Compared to anal fissures, colon cancer is a more severe condition and a significant health concern due to its potential seriousness and impact on the body. It arises from changes in the DNA of cells in the colon, leading to uncontrolled cell growth. 

These cells can form a mass known as a tumour, which can invade and destroy healthy tissue. Over time, these cancerous cells might spread to other body parts, known as metastasis. 

Colon cancer is staged based on how far it has spread, with stages ranging from 0 (early-stage, localised cancer) to IV (cancer that has metastasised to other body parts). 

To understand better, here’s a breakdown of symptoms, causes, and risk factors of colon cancer. 

Symptoms Of Colon Cancer

  • Persistent changes in bowel habits, including diarrhoea, constipation, or a change in stool consistency.
  • Appearance of red or dark blood in stool
  • Persistent abdominal cramps, gas, or pain that doesn’t go away.
  • Sensation of incomplete bowel evacuation.
  • Weakness or fatigue due to chronic blood loss leading to anaemia.
  • Unexplained weight loss, which occurs with advanced disease.

Causes Of Colon Cancer

  • Polyps: Precancerous growths in the colon or rectum can develop into cancer over time.
  • Genetic Mutations: Certain inherited gene mutations can increase the risk of colon cancer.

Risk Factors

The risk factors for colon cancer are diverse and include both lifestyle choices and medical conditions. 

  • Age: The risk increases with age, particularly after age 50.
  • Personal or Family History of Cancer: Increased risk if you or a close relative have had colon cancer or polyps.
  • Inflammatory Intestinal Conditions: Diseases like ulcerative colitis and Crohn’s disease can increase risk.
  • Diet and Lifestyle: A sedentary lifestyle combined with a low-fibre, high-fat diet that is high in red meat might increase the risk of certain health conditions. 
  • Diabetes and Obesity: Individuals with diabetes or insulin resistance are at risk of developing colon cancer, as well as those who are overweight or obese.
  • Smoking and Alcohol: Both can increase the risk of colon cancer due to carcinogens, which can weaken the immune system.

What Does Blood In Your Stool Mean

Due to the nature of both Anal Fissures and Colon Cancer, they may sometimes cause your anal canal to bleed. However, finding blood in your stool won’t always mean the same thing.

The colour and nature of the blood can provide vital clues about your health. However, any blood in the stool signals that you should consult with a healthcare professional. 

While it may be a symptom of a minor issue, it’s crucial to rule out serious conditions like colon cancer, which requires prompt medical attention. Seek immediate care if you experience:

  • Heavy or persistent bleeding.
  • Dizziness, weakness, or fainting, which could indicate significant blood loss.
  • Severe abdominal pain or discomfort.
  • A drastic change in bowel habits or stool consistency that persists for more than a few days.

Diagnosing Anal Fissures Vs Colon Cancer

The presence of an anal fissure does not indicate or lead to colon cancer. However, diagnosing these conditions is important since their symptoms can sometimes overlap accurately. Healthcare professionals and gastroenterologists use different diagnostic methods for each condition. 

Anal Fissure Diagnosis

Diagnosis for fissures usually involves a physical examination of the anal area and involves these procedures:

  • Visual Examination: A preliminary examination involves visually inspecting the anal area for any visible abnormalities, such as fissures, tears, or other signs of irritation.
  • Digital Rectal Exam (DRE): In some cases, a DRE may be performed to feel for any abnormalities or pain, which can help confirm the presence of an anal fissure.
  • Anoscopy: An anoscopy is another diagnostic tool used to visualise the lower part of the rectum and anal canal. It involves inserting a narrow, tube-like instrument called an anoscope into the anus for a more detailed examination of the area.

Colon Cancer Diagnosis

Diagnosing colon cancer is more comprehensive, involving a variety of tests such as:

  • Colonoscopy: This is the primary diagnostic procedure for colon cancer. A flexible, lighted tube with a camera (colonoscope) is inserted through the anus into the colon and rectum. This allows for a comprehensive examination of the entire colon, including detecting polyps or tumours.
  • Biopsies: During a colonoscopy, if suspicious areas, polyps, or tumours are identified, biopsies may be taken. A pathologist then analyses these tissue samples to determine if they are cancerous.
  • Imaging Tests: In addition to colonoscopy, imaging tests like CT (computed tomography) scans may be used to assess the extent of cancer and see if it has spread to nearby organs.

Managing Anal Fissure Vs Colon Cancer

The treatments for anal fissures and colon cancer are quite different due to the nature and severity of these conditions. Here’s an overview of the treatments for each:

Treatment For Anal Fissures

The goal of treatment for an anal fissure is to relieve pain, promote healing, and prevent a recurrence.

  • Lifestyle and Dietary Changes: Consuming more fibre and staying hydrated can help soften stools and manage symptoms.
  • Topical Medications: Creams and ointments available over the counter may contain ingredients like hydrocortisone or numbing agents to reduce inflammation and relieve pain.
  • Sitz Baths: Soaking the affected area in warm water for 10-15 minutes several times daily can help soothe discomfort and promote healing.
  • Prescription Medications: For chronic or severe anal fissures that do not respond to other treatments, medications like calcium channel blockers or nitrates may be prescribed to relax the anal sphincter muscles and improve blood flow.
  • Botulinum Toxin Injection: In some cases, a healthcare provider may inject botulinum toxin (Botox) into the anal sphincter muscle to relax it, reducing pain and promoting healing.
  • Surgery: Surgical intervention is typically reserved for cases that do not respond to conservative treatments. Procedures such as lateral internal sphincterotomy or fissurectomy may be performed to relieve muscle tension and facilitate healing.

Treatment For Colon Cancer

The treatment for colon cancer varies, depending on the stage of the cancer, its location, and the overall health of the patient. It often involves a combination of the following:

  • Surgery: Surgery is the primary treatment for early-stage colon cancer. The goal is to remove the tumour and any affected nearby lymph nodes. Depending on the extent of the cancer, different surgical procedures may be used, including polypectomy, local excision, colectomy, or bowel resection.
  • Chemotherapy: This procedure involves the use of drugs to kill cancer cells or stop their growth. It is often recommended after surgery, especially for advanced-stage cancers or when cancer has spread to nearby lymph nodes.
  • Radiation Therapy: Radiation therapy uses high-energy X-rays to target and destroy cancer cells. It may be used before surgery to shrink tumours or after surgery to kill any remaining cancer cells.
  • Targeted Therapy: Targeted therapies specifically target molecules or pathways involved in cancer growth. They may be used in combination with chemotherapy for certain types of colon cancer.
  • Immunotherapy: Immunotherapy works by enhancing the body’s immune system to recognise and attack cancer cells. It is sometimes used for advanced colon cancer.

Treatment plans are personalised for each patient, and decisions are made in consultation with a healthcare team, including surgeons, oncologists, and other specialists. 

Screening, such as colonoscopies, is recommended for individuals at risk or as part of routine healthcare for early detection and effective treatment plans.

Conclusion About Anal Fissures Vs Colon Cancer

While anal fissures and colon cancer both affect the digestive system, they differ significantly in terms of severity and treatment goals. 

Anal fissures primarily require measures to alleviate discomfort and facilitate healing, whereas colon cancer necessitates early diagnosis and comprehensive treatment for potential cure or improved quality of life.

For anyone experiencing symptoms or concerns related to these conditions, seeking professional advice is paramount. Dr. QM Leong from Advanced Colorectal and General Surgery is a trusted expert in this field who can provide the necessary guidance and care. 

As a skilled doctor specialising in treating diseases affecting the colon and rectum, we will carefully examine your symptoms and recommend a suitable treatment plan.

Schedule an appointment today!

Frequently Asked Questions About Anal Fissures Vs Colon Cancer

Can Anal Fissures Develop Into Colon Cancer?

Anal fissures do not cause colon cancer, nor do they increase the risk of developing it. Anal fissures are essentially localised injuries to the tissue and do not have a malignant potential.

The presence of an anal fissure does not imply colon cancer, and each condition has its distinct causes and should be evaluated separately by healthcare professionals.

Can Colon Cancer Patients Develop Anal Fissures?

Individuals with colon cancer may develop anal fissures, although this is not necessarily a common occurrence. Colon cancer can lead to changes in bowel habits and stool consistency, potentially contributing to conditions that might precipitate an anal fissure. 

What Happens To Untreated Anal Fissure?

An untreated anal fissure can lead to several complications, including chronic pain, muscle spasms, and worsening of the condition over time. There’s also a risk of developing more serious conditions such as abscess or fistula, which may require surgery. 

Is There A Recommended Age To Start Screening For Colon Cancer?

Generally, colon cancer screening is recommended for individuals starting at age 50. However, those with certain risk factors may need to start screening earlier.