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Rectal bleeding is a symptom of conditions like hemorrhoids, anal fissures, inflammatory bowel disease (IBD), ulcers and colorectal cancer. Typically, you notice rectal bleeding on toilet paper, in the water of the toilet bowl or in your stool. It’s important to contact your healthcare provider if you experience rectal bleeding because it could be a sign of a serious medical condition.


American Society for Gastrointestinal Endoscopy. Understanding Minor Rectal Bleeding. (https://www.asge.org/home/for-patients/patient-information/understanding-minor-rectal-bleeding) Accessed 8/13/2020.
Merck Manual Consumer Version. Polyps of the Colon and Rectum. (https://www.merckmanuals.com/home/digestive-disorders/tumors-of-the-digestive-system/polyps-of-the-colon-and-rectum) Accessed 8/13/2020.
Centers for Disease Control and Prevention. Inflammatory Bowel Disease (IBD): What Is It? (https://www.cdc.gov/features/inflammatory-bowel-disease/index.html) Accessed 8/13/2020.
Diet vs. Disease. Black, Green or Bloody: What’s Up With My Poop? (https://www.dietvsdisease.org/poop-stool-color/) Accessed 8/13/2020.
Canadian Society of Intestinal Research. The Scoop on Poop: 7 Answers to Common Questions. (https://badgut.org/information-centre/a-z-digestive-topics/the-scoop-on-poop/) Accessed 8/13/2020.
Colon Cancer Coalition. Colon Cancer Symptoms. (https://coloncancercoalition.org/get-educated/what-you-need-to-know/colon-cancer-symptoms/) Accessed 8/13/2020.
US Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. Gastrointestinal (GI) Bleeding. (https://www.niddk.nih.gov/health-information/digestive-diseases/gastrointestinal-bleeding) Accessed 8/13/2020.
Merck Manual Professional Version. Overview of Gastrointestinal Bleeding. (https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastrointestinal-bleeding/overview-of-gastrointestinal-bleeding) Accessed 8/13/2020.


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Looking down into a toilet and seeing blood can be alarming. Your mind might go to many places as alarm bells ring that something is wrong. This is often rectal bleeding. A symptom of many different medical conditions, rectal bleeding can vary from being mild to being a sign of a serious condition like colorectal cancer. If you’re experiencing rectal bleeding, you might see blood in a few different ways — on your toilet paper as you wipe, in the water of the toilet bowl or in your poop. It can be different colors, ranging from bright red to a dark maroon to black.
The color of blood you see can actually indicate where the bleeding might be coming from.
Sometimes, rectal bleeding isn’t visible to the naked eye and can only be seen through a microscope. This type of bleeding is usually found during a lab test of a stool sample.

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In some cases, rectal bleeding can be a minor symptom of a condition that can be easily treated. Hemorrhoids, for example, can cause you to experience rectal bleeding. This usually doesn’t last long and hemorrhoids are often easy to treat. However, rectal bleeding can sometimes be a sign of a serious condition like colorectal cancer. It’s important to keep track of any bleeding you are experiencing. If it’s heavy, frequent or causing you to worry, call your healthcare provider to check it out.
You might see or experience rectal bleeding in a few different ways, including:
Rectal bleeding can be bright red or darker in color. You can also have rectal bleeding without being able to see it. This can happen when you have very small amounts of blood in your stool — called occult bleeding.
When you have blood in your stool it can look a few different ways. You may have bright red streaks of blood on your poop or you could see blood mixed in with it. Stool could also look very dark, almost black, and tarry.
Sometimes, you can have blood in your stool that’s not visible. This is called occult bleeding. This can be a sign of bleeding inside your digestive tract. It can also signal a more serious condition like an inflammation disease in your intestines or cancer. Occult bleeding is usually found during lab tests that look at a sample of your poop to check for small amounts of blood. This is called a fecal occult blood test and it can be used as a way to screen for possible colorectal cancer. Your healthcare provider might recommend this if you have a family history of colorectal cancer.
One thing to keep in mind when you see an unusual color in your poop is what you ate. There are certain foods that can change the color of your stool and make it look red or even black. This is often mistaken for blood in your stool.
The symptoms of rectal bleeding can vary depending on what is causing the bleeding. Most causes of rectal bleeding are treatable and not serious. In some cases, rectal bleeding can be a symptom of a serious disease, such as colorectal cancer . Because it can be hard to know the cause of your rectal bleeding at home, it’s usually a good idea to reach out to your healthcare provider if you have rectal bleeding.
Some symptoms you might have with rectal bleeding can include:
In some very severe cases, rectal bleeding can lead to shock. If you experience any symptoms of shock, call 911 right away and get help. The symptoms of shock can include:
There are many different reasons why you might experience rectal bleeding. The causes of rectal bleeding can vary from common and mild conditions to more severe and rare conditions that need immediate medical treatment.
Causes of rectal bleeding can include:
There are certain foods that can make your poop an unusual color. You can have green, yellow and even black stool. This can happen for a variety of reasons – having too much bile during digestion, having a medical condition like inflammatory bowel disease or celiac disease, being on antibiotics, or even just eating foods with strong color pigments.
Often, blood can make your stool look very dark and almost black. Foods like black licorice, beets, dark berries (blueberries and blackberries) and red gelatin can all make your poop look very dark. This can easily be confused for blood in your stool. If you notice very dark poop during a bowel movement, think back to what you ate recently. There’s a chance that what you ate could be the cause for the usually dark stool.
Straining too hard during a bowel movement can cause rectal bleeding. This is often related to constipation . When you strain, you can cause conditions like hemorrhoids or anal fissures. Very hard stool can actually cause the skin around your anus to tear, causing you to see blood. Treating constipation can help prevent this from happening.
There are several ways your healthcare provider can evaluate rectal bleeding to help figure out the cause. Your provider might start by asking you about the situation around your rectal bleeding. Some questions may include:
These questions can help your healthcare provider narrow down a possible cause of your bleeding. There are also tests that your provider can do to help determine the cause.
Tests to help diagnose the cause of rectal bleeding can include:
Your healthcare provider may suggest only one of these tests, or do several of them together to try and discover the cause of your rectal bleeding.
The longer the blood is in your digestive tract, the darker it will typically look. This is because there are digestive chemicals in your body that naturally break down everything that moves through your digestive tract. The blood gets darker the longer it’s in contact with these chemicals. If your bleeding is higher up in the digestive tract, it might appear darker in the toilet. If you see bright red blood, that can mean it’s lower in your digestive tract or is moving through your body very quickly. While there are many benign (not harmful) causes of bright red bleeding, there are fewer benign causes of darker blood — for this reason, dark blood may be more concerning, and warrants workup by your healthcare provider.
In most cases, rectal bleeding can be treated by caring for the cause of the bleeding. Rectal bleeding is often a part of a bigger issue that needs to be taken care of. Once that condition has been treated, the bleeding usually stops. Treatment options can vary depending on the condition. Conditions like anal fissures can go away on their own over time or be treated with ointments. Hemorrhoids are another common cause of rectal bleeding that can be treated by either resolving any constipation issues, changing your diet and water intake, or possibly having surgery.
One more severe cause of rectal bleeding can be cancer. If this is the case, your healthcare provider will develop a treatment plan to treat the cancer, often removing any tumors.
Depending on the cause of the bleeding, your rectal bleeding can actually stop on its own. However, you need to pay attention to your body and keep track of the bleeding. If it happens one time and then stops, take note of it, but it most likely isn’t an emergency. If you have heavy rectal bleeding or are regularly seeing blood, reach out to your healthcare provider to get immediate care. It’s always a good idea to let your healthcare provider know about any rectal bleeding you have experienced.
It’s usually a good idea to reach out to your healthcare provider whenever you have rectal bleeding. It can be a sign of another health condition that might need treatment. If you have heavy bleeding or are seeing blood in multiple bowel movements, it’s urgent that you see your provider. Rectal bleeding can have serious causes that need to be treated.
If you’re experiencing rectal bleeding, calling your healthcare provider and going in for an appointment is often a good idea. Your provider will figure out what’s causing the bleeding and develop a plan to stop the bleeding.
It’s important to ask any questions you might have during this appointment. Don’t be embarrassed to talk about your bowel movements or details about your poop. This information might seem disgusting, but it will help your provider know what’s happening and find the best way to help you feel better.
Last reviewed by a Cleveland Clinic medical professional on 08/13/2020.

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Read about What Causes Rectal Bleeding & How to Treat It
Associate Professor of Medicine, Brigham and Women’s Hospital
Associate Professor of Medicine, Brigham and Women’s Hospital
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Every so often, when I go to move my bowels, when I wipe to clean myself I notice that there's blood on the toilet paper. The only conclusion I can come up with is that I might've irritated my hemorrhoids. I definitely need to stay away from the hot spices I put in my food while cooking. I'm going to share this with my primary care physician.

I've had 2 colonoscopies and the test results came back normal, but it's been 4 years since my last one so I'm going to ask my PCP to schedule me for another one. These are the precautionary steps I suggest anyone should take if they have the same or similar experience.
Associate Professor of Medicine, Brigham and Women’s Hospital
Abdominal pain is usually a sign of a common illness or infection. Other causes include indigestion, a stomach ulcer, IBS, or food poisoning.
Diarrhea is loose or watery stool, or having a stool at least 3 times in 24 hours. Common causes include viral gastroenteritis, bacterial infection, C. Diff colitis, medications, irritable bowel syndrome, and celiac disease.
Nausea is that queasy feeling in your stomach that makes you feel like you're going to vomit. Usually, nausea is from an infection, pregnancy, taking certain medication, or acid reflux.
References Understanding Minor Rectal Bleeding. American Society for Gastrointestinal Endoscopy. ASGE Link . Rectal Problems in Women. American College of Gastroenterology. ACG Link . Bleeding. U.S. National Library of Medicine: MedlinePlus. Updated April 23, 2018. MedlinePlus Link . Ellis BG, Thompson MR. Factors Identifying Higher Risk Rectal Bleeding in General Practice. British Journal of General Practice. 2005;55(521):949-955. NCBI Link . Shields HM, Stoffel EM, Chung DC, et al. Disparities in Evaluation of Patients with Rectal Bleeding 40 Years and Older. Clinical Gastroenterology and Hepatology. 2014;12(4):669-e33. NCBI Link . Constipation, Diarrhea and Bloody Stool. Digestive Healthcare Center. DHC Center Link . Anal Injury. healthdirect. Updated July 2017. healthdirect Link . Stein S. Anal Fissure. American Society of Colon and Rectal Surgeons. FASCRS Link . Muldoon R. Hemorrhiods. American Society of Colon and Rectal Surgeons. FASCRS Link . Proctitis. National Institute of Diabetes and Digestive and Kidney Diseases. Published August 2016. NIDDK Link . Foxx-Orenstein AE, Umar SB, Crowell MD. Common Anorectal Disorders. Gastroenterology & Hepatology. 2014;10(5):294-301. NCBI Link . Altomare DF, Binda GA, Canuti S, Landolfi V, Trompetto M, Villani RD. The Management of Patients with Primary Chronic Anal Fissure: A Position Paper. Techniques in Coloproctology. 2011;15(2):135-141. NCBI Link . Anal Fissures. Johns Hopkins Medicine. Johns Hopkins Medicine Link . Gastrointestinal Bleeding. U.S. National Library of Medicine: MedlinePlus. Updated April 30, 2018. MedlinePlus Link . Colon Polyps. National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK Link . Diverticular Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Published May 2016. NIDDK Link . Crohn's Disease. National Institute of Diabetes and Digestive and Kidney Diseases. NIDDK Link . Gastrointestinal (GI) Bleeding. National Institute of Diabetes and Digestive and Kidney Diseases. Published July 2016. NIDDK Link . Peptic Ulcers (Stomach Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases. Published November 2014. NIDDK Link . Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. Published October 2016. NIDDK Link .
Take a quiz to find out what's causing your rectal bleeding.
If you notice bright, red blood right after a bowel movement, you may have rectal bleeding. A bleeding rectum can be commonly caused by anal fissures, hemorrhoids, or chronic constipation.
Take a quiz to find out what's causing your rectal bleeding.
It may be shocking to notice bright red blood in the toilet bowl or on the toilet tissue; however, rectal bleeding is more common than you think. Some causes are serious, but most of the time the bleeding is not dangerous and can be treated.
If you're experiencing rectal bleeding, it can likely be described by:
Rectal bleeding may be acute or chronic depending on the cause.
Adults over age 40 are probably most often affected . Children can also experience rectal bleeding especially with severe and chronic constipation or diarrhea.
Rectal bleeding often begins with chronic constipation from the straining and pressure on the walls of the rectum. Bleeding may also occur when there is chronic diarrhea because of irritation and inflammation of tissues.
The severity of rectal bleeding is ultimately dependent on the cause.
Many conditions can have rectal bleeding as a symptom. The most common are those involving constipation and hemorrhoids. However, bowel diseases, sexual activity, sexually transmitted infections, and tumors of the rectum or anus can also cause bleeding.
The most common causes of rectal bleeding include the following.
The following are less likely to cause rectal bleeding.
The following are more rare, although possible, causes of rectal bleeding.
Crohn's disease is an inflammation of the bowel. It is caused by a faulty immune system response which makes the body attack the lining of the intestines.
The disease usually appears before age thirty and can affect anyone. Those with a family history may be most susceptible. Smoking is a known risk factor.
Aggravating factors include stress, poor diet, and nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin.
Early symptoms usually develop gradually, but can appear suddenly. These include fatigue, loss of appetite, fever, mouth sores, diarrhea, abdominal pain, and blood in stool.
Untreated Crohn's disease can cause ulcers throughout the digestive tract as well as bowel obstruction, malnutrition, and deteriorating general health.
Diagnosis is made through blood test and stool sample test. Colonoscopy, CT scan, MRI, endoscopy, and/or enteroscopy may also be used.
Crohn's disease cannot be cured, but can be managed through reducing the inflammation. Antibiotics, corticosteroids, and immune system suppressors may be tried. Excellent nutrition, vitamin supplements, smoking cessation, and reduction in stress can be helpful.
Top Symptoms: fatigue, stomach bloating, loss of appetite, constipation, abdominal cramps (stomach cramps)
Take a quiz to find out what's causing your rectal bleeding.
The digestive, or gastrointestinal (GI), tract includes the esophagus, stomach, small intestine, large intestine, rectum, and anus. Lower gastrointestinal bleeding refers to internal bleeding from the large intestine, rectum, or anus, usually caused by hemorrhoids, ischemic bowel disease, or inflammatory bowel disease.
Call 911 immediately for an ambulance now if the bleeding is severe. Otherwise, you should seek immediate medical care at an urgent care clinic or ER. A medical team will evaluate this critical condition and determine if surgical intervention is needed to stop the bleeding.
Top Symptoms: rectal bleeding, severe rectal bleeding, moderate rectal bleeding
When the passage of food through the colon becomes sluggish, the food can stagnate, increase in bulk, create pressure, and cause diverticula – or pouches – to form in the walls of the large intestine. If these pouches become inflamed, the condition is called diverticulitis .
Risk factors are a low-fiber diet, smoking, obesity, chronic constipation, and lack of "good" bacteria in the gut.
Patients over 50, with a previous history of inflammatory disease of the colon, are most susceptible.
Symptoms include persistent abdominal pain; fever; nausea and vomiting; and constipation sometimes alternating with diarrhea.
Left untreated, diverticulitis can lead to intestinal blockage and scarring. Rupture of an inflamed pouch can result, leading to peritonitis. These are medical emergencies. If suspected, take the patient to the emergency room or call 9-1-1.
Diagnosis is made by ruling out other conditions through physical examination; blood, urine, and stool tests; and CT scan.
Less serious cases are treated with a high-fiber diet, fluids, probiotics, antibiotics, and lifestyle management. Others may require intravenous antibiotics and/or surgery.
Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite,
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