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Can severe internal hemorrhoids lead to cancer?

Feb 24, 2025 Source: Cainiu Health
Dr. Li Jingxiang
Introduction
Internal hemorrhoids are a type of venous tumor formed by the dilation, tortuosity, and nodular protrusion of the venous plexus within the wall of the rectal and anal region. They are benign lesions primarily caused by factors such as chronic constipation, prolonged sitting, and poor dietary habits. They do not possess the biological characteristics of malignant tumors, such as uncontrolled cell proliferation, invasion of surrounding tissues, or distant metastasis.

In general, internal hemorrhoids do not become cancerous, even when severe. If there are concerns, it is recommended to seek medical attention promptly. Detailed explanation is as follows:

Internal hemorrhoids are a type of venous malformation characterized by the dilation, tortuosity, and protrusion of the venous plexus within the rectal and anal region. They are considered benign lesions, primarily caused by factors such as chronic constipation, prolonged sitting, and poor dietary habits. They do not possess the biological characteristics of malignant tumors, such as uncontrolled cell proliferation, invasion of surrounding tissues, or distant metastasis. Therefore, internal hemorrhoids themselves do not transform into cancer.

Although internal hemorrhoids are not cancerous, long-standing hemorrhoids may lead to complications such as anal infection and anemia. Additionally, if a patient with internal hemorrhoids experiences recurrent blood in the stool, this symptom should not be simply attributed to hemorrhoids alone. The possibility of other gastrointestinal diseases, such as rectal cancer, should be considered. In such cases, timely medical consultation is recommended, and diagnosis should be confirmed through methods like digital rectal examination or colonoscopy.

Maintain a light diet, consume more fiber-rich foods, and avoid spicy, irritating foods and excessive alcohol consumption. Additionally, develop good bowel habits and avoid prolonged straining or sitting on the toilet for extended periods.

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How to treat internal hemorrhoids
Treatment for internal hemorrhoids mainly includes general management, medication, sclerotherapy, rubber band ligation, and surgical intervention, with the appropriate approach selected according to disease severity. Prompt medical attention is required if symptoms such as worsening rectal bleeding, prolapsed hemorrhoidal tissue that cannot be reduced, or severe pain occur. For mild internal hemorrhoids, treatment involves adjusting diet by increasing dietary fiber intake and establishing regular bowel habits.
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Can a colonoscopy detect internal hemorrhoids?
A colonoscopy can detect internal hemorrhoids, clearly revealing their location, size, number, and mucosal condition, while simultaneously screening for other intestinal abnormalities. If symptoms such as rectal bleeding, anal heaviness, abdominal pain, or changes in bowel habits occur, prompt medical evaluation is recommended. Internal hemorrhoids are located at the distal end of the rectum near the anus, and a colonoscope can be inserted through the anus into the rectum and colon to directly visualize the morphological characteristics of the hemorrhoids.
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What are the harms of internal hemorrhoids?
If internal hemorrhoids are neglected or not promptly treated over a long period, they may generally lead to persistent bleeding during bowel movements and anemia, worsening prolapse of hemorrhoidal tissue, perianal infections, difficulty in defecation, and reduced quality of life. In the early stages, internal hemorrhoids often cause dripping blood during bowel movements or blood-streaked toilet paper. Long-term, recurrent bleeding results in loss of iron from the body, gradually leading to iron-deficiency anemia, which manifests as dizziness, fatigue, and pale complexion.
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What is the difference between rectal prolapse and internal hemorrhoids?
Internal hemorrhoids occur in the submucosal layer of the distal rectum above the dentate line. They are soft masses formed by varicose hemorrhoidal venous plexuses, located relatively deep; in early stages, the prolapsed tissue is mostly hemorrhoidal nodules. Rectal prolapse, on the other hand, involves protrusion of the rectal mucosa or full-thickness rectal wall. The prolapsed portion consists of rectal wall tissue, located lower down and potentially involving the distal rectum or even part of the sigmoid colon.
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What does internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids mean?
Internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids are the three main types of hemorrhoidal disease. Internal hemorrhoids are located above the dentate line, external hemorrhoids below the dentate line, while mixed hemorrhoids span across the dentate line, exhibiting features of both internal and external hemorrhoids and often presenting more complex symptoms. Persistent rectal bleeding or prolapsed and incarcerated hemorrhoidal tissue warrants timely medical evaluation. Internal hemorrhoids arise from the hemorrhoidal venous plexus beneath the mucosa and are typically not associated with significant pain.
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What are the symptoms of internal hemorrhoids?
Symptoms of internal hemorrhoids include rectal bleeding, prolapse of hemorrhoidal tissue, perianal itching, a sensation of heaviness or fullness in the anus, and discomfort during defecation. The severity of symptoms is related to the size of the hemorrhoidal tissue and disease progression, and the condition should be assessed based on specific clinical presentations. Prompt medical attention is recommended if there is heavy bleeding or if prolapsed tissue cannot be reduced. Bright red blood may appear during or after bowel movements, presenting as dripping blood, jet-like bleeding, or blood on toilet paper.
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What should I do if I have bleeding during bowel movements due to internal hemorrhoids?
In general, the treatment methods for bleeding internal hemorrhoids mainly include conservative management, local medication, oral drug therapy, physical therapy, and surgical treatment. In addition, patients should follow medical advice for standardized treatment and undergo regular follow-up examinations. If abnormal conditions such as heavy or persistent bleeding occur, timely medical consultation is necessary to adjust the treatment plan.
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