It can be strange – and a little scary – to see streaks of blood in your poop, bright red water in the toilet or scarlet spots on your toilet paper.
The first thing to know is that rectal bleeding and bloody poop usually aren’t anything to worry about. Still, there’s a small chance that when you see red in your poop or after a bowel movement, it could be a sign of a medical condition. So in most cases, you’ll want to talk to a doctor or clinician if you notice bloody stools or rectal bleeding.
But first, read on to learn about the causes of rectal bleeding and bloody stools, and what to do next.
What is rectal bleeding?
Rectal bleeding means that blood is exiting your body through your rectum or anus. Your rectum is the name for the part of the large intestines right before your anus. Your anus is the opening on your bottom where poop leaves your body.
Rectal bleeding can start in your rectum or anus. But it’s also possible for the bleeding to start at other places in your digestive system, including your stomach and small intestines. This is still considered rectal bleeding since the blood will leave your body through your rectum.
Signs and symptoms of rectal bleeding
Blood from rectal bleeding can come out in your poop or in liquid form. So if you have rectal bleeding, you may notice blood on toilet paper, in the toilet water, or poop that’s an unusual color or has red spots in it.
Blood on toilet paper after wiping
Blood on the toilet paper is usually bright red. Most of the time, it’s not a sign of a serious condition, but if it keeps happening, check in with your doctor. It could be that you need treatment for hemorrhoids or an anal fissure, common conditions that are discussed later in this post.
Bright red blood in the toilet
If you have bleeding in your rectum or anus, blood may briefly coat the stool when it lands in the water. It’s also possible for blood to dribble in after a bowel movement. As it spreads out, it can look like red food coloring in water. You’ll want to talk to your doctor if you see blood in the toilet, especially if it looks like a large amount.
Blood in or on your poop
You may not see blood in the toilet or on the toilet paper if you have rectal bleeding. That’s because blood from rectal bleeding can mix into your poop. Blood in poop has spent longer in your digestive system, meaning that the bleeding is likely from your stomach, small intestine or higher up in your large intestines.
Bloody poop can be a sign of a serious medical condition. So, make a doctor’s appointment if you see blood in your stool.
What bloody stools can look like
If you have blood in your stools, it can change the overall color of your poop, or you could have streaks or spots of blood in the stool.
Colors that may mean there’s blood in your stool
Bloody stools can be different colors, based on where the bleeding is coming from. That’s because blood changes color as it’s broken down by the digestive chemicals – the longer it spends in your digestive system, the darker it gets. This means that:
- Poop that’s nearly black could be caused by bleeding in the stomach or small intestines.
- Poop that’s dark red or maroon could be caused by bleeding in your small intestines or in the upper part of your large intestines.
- Bright red poop could be caused by bleeding from the rectum or anus. It could also be caused by a serious problem in your stomach or small intestines that’s causing you to bleed a lot over a short time.
It’s also possible to have blood in your stool that you can’t see. This type of bleeding is called occult bleeding and it can be found when you use a test like the fecal immunochemical test (FIT).
In a severe case, bleeding could come from variations of these sources if it occurs at a rapid pace and in large quantities. If this happens, seek immediate emergency care.
Common causes of rectal bleeding and colored stools
There are many potential causes for rectal bleeding and bloody stools. Most aren’t serious and are easily treated.
Food and medications that affect poop color
Blood isn’t the only reason why poop can look reddish or black. Food and medications can affect poop color and texture. So if your poop doesn’t seem right, it’s a good idea to think about what you’ve been eating.
Reddish stools can be caused by eating lots of beets, cranberries, red gelatin and tomato juice. Antibiotics like cefdinir can also cause red poop. But antibiotics can cause intestinal bleeding, so you shouldn’t ignore red poop if you’re on antibiotics.
Reasons for dark or blackish stools include foods like blueberries, chocolate and leafy greens. You may also have black poop after taking iron supplements or bismuth medications such as Pepto Bismol. Iron supplements can also cause constipation, which is a cause of rectal bleeding that’s covered later in the post.
Most rectal bleeding comes from hemorrhoids, which are swollen veins in the rectum or anus. Other common symptoms of hemorrhoids include an itchy bottom and discomfort when sitting.
Hemorrhoids develop when there’s increased pressure on the lower rectum. Possible causes for the extra pressure include chronic constipation, straining while pooping, spending long periods of time on the toilet (such as scrolling your phone or reading the newspaper), pregnancy, lifting heavy objects, having anal intercourse and being overweight.
Hemorrhoids usually aren’t anything to be concerned about. They sometimes go away on their own, but it’s a good idea to talk to a doctor about a treatment plan.
Dealing with constipation can be a literal struggle. It can take a lot of straining and sometimes the stool that comes out is extremely hard or very large. And, unfortunately, all that straining and stretching can cause swelling and tears that lead to bleeding.
It’s not unusual to get constipated. But chronic constipation can be a sign of medical conditions. So if you consistently go less than three times a week, talk to your doctor.
When you have diarrhea, it can make your anus red and sore. But once you’ve gotten over your diarrhea, it usually won’t take long for your bottom to feel better.
If you have diarrhea for a long time, it can cause swelling or a tear near your anus. Chronic diarrhea can be a sign of other medical conditions. So if it lasts for more than four weeks, talk to your doctor to find out what’s causing it.
An anal fissure is a tear in the skin around the anus. Reasons for anal fissures include straining to poop, very hard stools, chronic diarrhea and anal intercourse.
If you have an anal fissure that’s causing your rectal bleeding, you’ll likely feel pain or a burning sensation when you poop – and sometimes for hours afterwards. Anal fissures typically go away with home remedies. A doctor can help determine which treatments would be best for you.
Anal abscesses or fistulas
You have small glands in your anus that help you pass stool. But it’s possible for these glands to get infected and filled with puss – when this happens it’s called an anal abscess.
If you have an anal abscess, your body may create a fistula or a tunnel from the abscess to the skin around the anus. This is your body’s way of trying to drain the puss out of the abscess.
Abscesses and fistulas can cause rectal bleeding and discharge. And because they’re caused by infection, you may get a fever or chills. Anal abscesses and fistulas need to be treated by a doctor.
Peptic ulcers are sores in the lining of the stomach or the upper part of the small intestines. Ulcers are usually caused by unbalanced digestive fluids, often from frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen.
Ulcers can also be caused by helicobacter pylori (H. pylori), which is a common stomach bacteria. Up to half of the people in the world may have it, but many don’t know it’s there because they don’t have any symptoms. If you have stomach ulcers, your doctor will likely test you for a H. pylori infection.
The most common symptoms are stomach pain, bloating, heartburn or nausea. Sometimes peptic ulcers can bleed, and the blood will show up in your poop. You might notice dark spots of blood in your stools, blackish stool or stools that look tarry. This is a more serious symptom of ulcers, and you should see a doctor.
Inflammatory bowel disease
If you have inflammatory bowel disease (IBD), it means your digestive tract tissues are chronically inflamed and swollen. When your body tries to digest food, you may experience symptoms such as diarrhea, stomach pain and the need to pass stools frequently.
Rectal bleeding can be a common symptom of IBD, depending on the severity of your condition. If you have a mild or moderate case, you’ll likely only have occasional bloody stools. But if you have a severe case, it’s possible to have 10 or more bloody bowel movements in a day. If you have the symptoms of IBD, make an appointment with a doctor. They can diagnose your condition and offer therapies to help with your symptoms.
Many people have small pouches called diverticula in the weakened parts of their large intestines. Usually, these pouches don’t cause any symptoms. However, if these pouches become inflamed, it could cause a condition called diverticulitis that includes complications like bleeding and infections. If you have symptoms like vomiting, abdominal pain and fever, you should make a doctor’s appointment.
Polyps are clumps of abnormal tissue that can grow on the lining of your intestine. Polyps don’t usually cause any symptoms, so it’s unlikely that you’d know if you had them. But sometimes polyps can bleed or turn into cancer.
Blood in your poop can mean that you have larger polyps. And your doctor may recommend you get a colonoscopy for cancer screening to make sure that you don’t have polyps that are cancerous or precancerous. But it’s rare that blood in stool means that you have cancer – research shows that cancer is the cause of bloody stools only 3.4% of the time.
Does rectal bleeding go away on its own?
It’s possible for rectal bleeding to go away on its own, but it really depends on what’s causing the bleeding. Common causes of rectal bleeding, like hemorrhoids and anal fissures, often heal without special treatment. But you may need care for other conditions. The best first step is to make an appointment with a primary care doctor. Primary care doctors and clinicians can diagnose and treat hundreds of conditions, as well as refer you to a specialist for more advanced care if needed.
Should you worry about blood in stool or rectal bleeding
If there’s one time when you see a little blood in the toilet or on the tissue only, it’s probably not a big deal – especially if you’re not experiencing other symptoms.
But it’s important to see a doctor if you frequently have rectal bleeding or bloody stools. Chances are it’s nothing to be concerned about. But if it’s something more serious, like colorectal cancer, early diagnosis greatly increases the chance that treatment will be successful.
A good place to start is with your primary care doctor. To help diagnose the problem, they’ll ask questions about the bleeding, how much it happens and when it occurs. So, it’s a good idea to keep track of times that you’ve had bleeding or bloody poop, and if you have other symptoms. This information can help your doctor diagnose the cause of your rectal bleeding.
While it may feel embarrassing to talk about your symptoms, know that your doctor is used to having these conversations – and they want to know all the details. Because there are so many causes of bloody stools, the more they know, the better they can help determine a diagnosis and next steps in treatment.
Depending on your symptoms, your doctor may recommend tests such as a colonoscopy to identify conditions that could cause rectal bleeding. They may also refer you to a digestive health specialist for testing and treatment.
When to go to urgent care or the emergency room for blood in your stool
If you’re seeing a lot of blood or have severe abdominal pain or cramping, ask someone to drive you to urgent care.
Very rarely, rectal bleeding results in shock. Call 911, if you experience any of the following:
- Weakness or fatigue
- Rapid pulse
- Rapid breathing
Talk to your doctor and stop worrying about bloody stools
It’s always a good idea to talk to your doctor if you’re experiencing rectal bleeding or bloody stools. While it’s unlikely that your rectal bleeding is being caused by something serious, they’ll have recommendations to help you heal more quickly – and help you get necessary treatment for more serious conditions like colorectal cancer, IBD or infections.