Rectal Bleeding (Blood in Stool)

What is rectal bleeding?

Rectal bleeding is when blood comes out of your anus. You might see this as blood in your stool (poop), blood on toilet paper when you wipe or blood in the toilet bowl. Seeing blood can be alarming, and your mind may race as you start to worry that something is wrong.

Blood in your poop can come from different areas of your digestive system. Sometimes, it comes from your anus (butthole), like with hemorrhoids. Sometimes, it comes from higher up, like from an issue with your stomach.

What does blood in stool look like?

Blood in your poop can look a few different ways. You may only notice it when you wipe. You may have bright red streaks of blood on your poop. You may even see blood that contains mucus. Your poop could also look dark, black and tarry instead of bright red.

The color of the blood you see may be a clue to where it’s coming from:

• Bright red blood in your stool usually means the bleeding is lower in your colon, rectum or anus. The medical term for this is hematochezia.
• Dark red or maroon blood can mean that you have bleeding higher up in your colon or your small intestine.
• Melena (black stool) often points to bleeding in your stomach.

Blood in stool causes

There can be many different causes. Some of the most common causes of rectal bleeding include:

• Hemorrhoids: Hemorrhoids are swollen veins in your rectum or anus. They’re the most common cause of blood in stool. They’re usually not serious and often happen from straining too hard when you poop due to constipation.
• Anal fissure: An anal fissure is a tear in the lining of your anal canal. Like a hemorrhoid, it often happens after straining to poop. Anal fissures can cause pain and bleeding.
• Inflammatory bowel disease (IBD): IBD causes inflammation in the lining of your small and large intestines. Crohn’s disease mostly affects your small intestine, while ulcerative colitis mostly affects your large intestine.
• Diverticulitis: Diverticulitis happens when little pockets in the inner lining of your colon become infected and inflamed. Inflammation in these pockets can make the blood vessels inside more fragile and more likely to rupture. If this happens, it can cause bleeding.

Other possible causes include:

• Gastroenteritis: This is a general term for inflammation or infection of your stomach and intestines. It can sometimes lead to diarrhea that contains blood.
• Infectious colitis: Some bacterial infections, like E. coli and C. diff, can cause bleeding from your colon. This usually comes in the form of bloody diarrhea.
• Peptic ulcer disease: Peptic ulcers are open sores in your stomach or upper small intestine that form when stomach acid damages the protective lining. It can cause bleeding and make your poop dark, black and tarry.
• Colon polyps and colorectal cancer: Colon polyps and colon cancer can cause bleeding when abnormal tissue becomes irritated or damaged. When poop passes through, it can rub against these growths and cause them to bleed.
• Medications: Medications that thin your blood, prevent clotting or irritate your digestive tract can cause rectal bleeding.

What are symptoms associated with blood in your stool?

Blood in your poop can come with other symptoms. Depending on the exact cause, you may also have:

• Abdominal or rectal pain
• Vomiting and nausea
• Unexplained weight loss
• Fatigue or dizziness

How do healthcare providers determine the cause of blood in your stool?

There are many ways your provider can figure out the cause. They might start by asking questions about your pooping habits. They’ll also ask about other symptoms or health conditions you have. Your answers can help them determine which tests you may need.

They may start with a digital rectal exam to check for hemorrhoids or issues in your rectum. Then, your provider may order one of the following tests:

• Anoscopy or proctoscopy to look at your anus and lower rectum
• Flexible sigmoidoscopy to check your lower colon
• Fecal occult blood test to find hidden blood in your stool
• Colonoscopy to examine your entire colon
• Upper endoscopy to look for bleeding in your stomach or small intestine

You probably won’t need all these tests. Your provider will decide which one is best based on your symptoms.

Blood in stool treatment

In most cases, rectal bleeding treatment involves treating an underlying cause.

If hemorrhoids are the cause, you may be able to treat them at home with medicated creams, warm baths or by adding more fiber to your diet to ease constipation. If bleeding is due to an infection, you may need antibiotics. More serious causes may require surgery.

Sometimes, the bleeding stops quickly. Other times, you need ongoing treatment from a healthcare provider.

When should I see a doctor about rectal bleeding?

Contact a healthcare provider if you notice blood in your poop or in the toilet bowl. There can be many causes of blood in your stool. Even if you think you know the cause, seeing a healthcare provider is the best way to get answers and make sure it’s nothing serious.

Seek immediate medical care if the bleeding is heavy or doesn’t stop, or if you have symptoms like severe pain or dizziness with it.