What Causes Rectal Hemorrhage?

Conditions list medically reviewed by George Krucik, MD, MBA

If you finish going to the bathroom and notice a small amount of bright-red to black blood in the toilet bowl, on the toilet paper, or in your stool, you’re experiencing rectal bleeding. Rectal bleeding has many causes and can occur as the result... Read More

What does rectal bleeding mean?

If you finish going to the bathroom and notice a small amount of bright-red to black blood in the toilet bowl, on the toilet paper, or in your stool, you’re experiencing rectal bleeding.

Rectal bleeding has many causes and can occur as the result of a weaker or abnormal area along your digestive tract. According to the Cleveland Clinic, hemorrhoids are the most common cause of rectal bleeding. While these and other causes of rectal bleeding may be minor inconveniences, rectal bleeding can be a real concern if you’re losing a lot of blood.

What are the signs of rectal bleeding?

The most apparent sign of rectal bleeding is red blood on toilet tissue or visible blood or red-tinged stool in the toilet bowl. However, it is important you pay attention to the coloring of the blood (and the color of your stools) as it can indicate different things:

  • Bright red blood indicates bleeding somewhere in the lower gastrointestinal tract, such as the colon or rectum.
  • Dark red or wine-colored blood may indicate bleeding in the small intestine or early portion of the colon.
  • Black, tarry stools may indicate bleeding from the stomach or the upper part of the small intestine.

Additional symptoms associated with rectal bleeding include:

  • confusion
  • fainting
  • feeling dizzy
  • rectal pain
  • abdominal pain or cramping

What causes rectal bleeding?

Causes of rectal bleeding can range from mild to serious. Mild causes associated with rectal bleeding include:

  • anal fissures or small tears in the lining of the anus
  • constipation or passing hard, dry stools
  • hemorrhoids or veins in the anus or rectum that become irritated
  • polyps, or small tissue growths in the lining of the rectum or colon that can bleed after passing stool

More serious rectal bleeding causes include:

Less common rectal bleeding causes include blood-clotting disorders and allergic reactions to certain food types.

When should I seek medical help?

Severe rectal bleeding can constitute a medical emergency. Go to an emergency room if you experience the following additional symptoms:

  • cold, clammy skin
  • confusion
  • continuous rectal bleeding
  • fainting
  • painful abdominal cramping
  • rapid breathing
  • severe anal pain
  • severe nausea

Make an appointment to see your doctor if you experience less severe rectal bleeding, such as small drops of blood from the rectum. However, because a small amount of rectal bleeding can quickly turn into a large amount, seeking treatment in early stages is important.

How is rectal bleeding diagnosed?

Your doctor will start by asking you about your symptoms. Questions may include when you first noticed the bleeding, related symptoms you’re experiencing, and what color the blood is.

Doctors most often perform a visual and/or physical exam to check the affected area. This can include inserting a gloved, lubricated finger into the anus to check for abnormalities, such as hemorrhoids.

Sometimes rectal bleeding may require endoscopic procedures. This involves inserting a thin, flexible lighted scope into the anus. The scope has a camera on the end, which allows the doctor to view the area to pinpoint any bleeding signs. Examples of endoscopic procedures to view rectal bleeding include a sigmoidoscopy or a colonoscopy.

A doctor may also order a blood test, such as a complete blood count (CBC) to determine if you’ve lost a significant amount of blood.

How is rectal bleeding treated?

Rectal bleeding treatments depend upon the cause and severity.

You may relieve the pain and discomfort of hemorrhoids by taking warm baths. Applying over-the-counter or prescription creams can also reduce irritation. Your doctor may perform more invasive treatments if your hemorrhoid pain is severe or the hemorrhoids are very large. These include rubber band ligation, laser treatments, or surgical removal of the hemorrhoid.

Like hemorrhoids, anal fissures may resolve on their own. Using stool softeners can address issues with constipation and help anal fissures to heal. Infections can require antibiotic therapy to eliminate the bacteria.

Colon cancers may require more invasive and long-term treatments, such as surgery, chemotherapy, and radiation to remove the cancer and reduce the risk of recurrence.

At-home treatments to prevent constipation can reduce the risk of rectal bleeding. These include:

  • eating high-fiber foods (unless otherwise directed by your doctor)
  • exercising regularly to prevent constipation
  • keeping the rectal area clean
  • staying well hydrated
Medically reviewed by Michele Cho-Dorado, MD on December 13, 2017Written by Rachel Nall, RN, BSN

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This feature is for informational purposes only and should not be used to diagnose. Please consult a healthcare professional if you have health concerns.

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