How to distinguish between anal fissure and rectal cancer causing rectal bleeding

Written by Yan Chun
Oncology
Updated on March 01, 2025
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In clinical practice, to differentiate between rectal bleeding caused by anal fissures and that caused by rectal cancer, we can consider the following aspects. Firstly, rectal bleeding caused by anal fissures is generally accompanied by pain in the anal area, and the bleeding is especially severe after defecation, with blood attached to the surface of the stool. In contrast, rectal bleeding caused by rectal cancer rarely accompanies pain in the anal area, and the blood is generally mixed with the stool. Secondly, rectal bleeding from anal fissures is usually due to hard stools, and improving the condition of hard stools, along with providing local anti-inflammatory treatment, usually relieves the symptoms of bleeding. However, in the case of rectal cancer, besides hard stools, patients may also experience an increase in the frequency of defecation and signs of diarrhea, and typical anti-inflammatory treatments are not notably effective.

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