Rectal Bleeding Symptoms
It may be something of a shock to notice bright red blood in the toilet bowl or on the toilet tissue, but rectal bleeding is more common than you might think. Some causes are serious, but most of the time the bleeding is not dangerous and can be readily treated [1, 2, 3].
- There will bright red blood from the rectum, which most commonly appears during or just after having a bowel movement.
- There may be pressure or discomfort in the rectum at the time of the bleeding.
- If the blood is coming from higher up in the intestine and is therefore contained within the stools, the stools will appear black or maroon in color [1, 3].
- An acute episode of rectal bleeding is one that occurs suddenly, with perhaps a large amount of blood evident.
- Chronic rectal bleeding may happen on and off for months or years, with only a small amount of blood present. It never seems to get better or to get worse.
Who is most often affected by rectal bleeding?
- Adults over age 40 are probably most often affected [4, 5].
- However, anyone can have the symptom of rectal bleeding, including children, especially if there has been severe and chronic constipation or diarrhea[3, 6].
When is rectal bleeding most likely to occur?
- Rectal bleeding often begins in the presence of chronic constipation due to the ongoing straining and pressure on the walls of the rectum.
- Bleeding may also occur when there is chronic diarrhea, because of the irritation and inflammation that this causes in the tissues.
Is rectal bleeding serious?
- An occasional and very small amount of blood, especially in the presence of hemorrhoids and/or constipation, is most likely not serious .
- However, if there is rectal pain or bleeding that become chronic, especially if these occur along with other symptoms of intestinal illness, you should see your medical provider so that tests can be done and treatment can be given.
Rectal Bleeding Causes
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 .
Most common cause types:
- Fissures, or tearing and bleeding, of the rectal or anal tissue .
- Hemorrhoids, which are swollen veins either inside the rectum or beneath the outer skin of the anus . These enlarged veins can bleed easily under additional pressure, such as when you are having a bowel movement.
Less common cause types:
- Bowel diseases, many of which cause irritation and inflammation of the lining of the intestines.
- Polyps, which are benign growths in the wall of the intestine and can become malignant if not removed.
- Sexual activity of any kind that causes trauma to the anus and/or rectum, including infection with sexually transmitted diseases that damage these tissues .
Rare & unusual cause types:
- Rectal ulcers, which are sores within the lining of the rectum. These are most often due to chronic, ongoing constipation and the subsequent straining .
- Proctitis, which is any inflammation of the lining of the rectum .
- Colon, rectal, or anal tumors, as well as the radiation therapy that may be used to treat them.
9 Possible Rectal Bleeding Conditions
The list below shows results from the use of our quiz by Buoy users who experienced rectal bleeding. This list does not constitute medical advice and may not accurately represent what you have.
Hemorrhoids, also known as piles, are swollen veins in your anus and lower rectum that can cause pain, itching, and rectal bleeding. Hemorrhoids may be seen or felt on the outside of the anus (external) or may be hidden from view inside of the rectum.
Hemorrhoids are common occurring in 10 million Americans per year, or about 4.4 percent of the population.
Hemorrhoids are bothersome but they do not usually cause serious health problems. Hemorrhoids may go away on their own, or may be treated with lifestyle changes, medications, or surgery depending on personal preference and severity.
Top Symptoms: constipation, rectal pain, rectal bleeding, pain when passing stools, anal itching
Symptoms that never occur with hemorrhoids: unintentional weight loss
Chronic or recurrent hemorrhoids
Chronic, or recurrent, hemorrhoids are swollen veins in the anus and rectum that never really resolve and may be symptomatic more or less constantly.
Hemorrhoids are caused by anything that puts pressure on the anus from the inside, such as straining during bowel movements; constipation; pregnancy; or anal intercourse.
Most susceptible are pregnant women and older people, though anyone can be affected.
Symptoms include a small amount of bleeding during or after a bowel movement, as well as discomfort, itching, or swelling around the anus.
A medical provider can suggest treatment to ease the symptoms of chronic hemorrhoids, as well as make certain of the diagnosis since other, more serious conditions can have symptoms similar to hemorrhoids.
Diagnosis is made through patient history and physical examination.
Treatment most often involves simple lifestyle changes such as drinking more water; adding fiber-rich foods to the diet; using fiber supplements and stool softeners; not delaying, or straining, to pass a bowel movement; and using topical medications. Surgical procedures to remove the hemorrhoid can be used in some cases.
Top Symptoms: rectal bleeding, rectal pain, pain when passing stools, anal itching, painless rectal bleeding
Symptoms that never occur with chronic or recurrent hemorrhoids: unintentional weight loss
An anal fissure is a break, or tear, in the mucous membrane lining of the anus. The anus is the opening at the end of the digestive tract where stool leaves the body. A fissure is caused primarily by constipation, which leads to straining to pass large hard stools; trauma caused by insertion of objects or by anal sex; and illnesses such as any type of inflammatory bowel disease or sexually transmitted disease.
Symptoms include pain and bleeding during and after a bowel movement, discomfort and difficulty with urination, and a visible tear resembling a crack in the anal tissue that may have a foul-smelling discharge.
Treatment primarily involves limiting constipation and thus straining by consuming more fiber and fluids, as well as easing anal irritation by soaking in a warm bath and gently cleansing the tissues of the anus. In some cases, medicated creams or suppositories may be prescribed.
Top Symptoms: rectal pain, pain when passing stools, painful rectal bleeding, hard stools, mild rectal bleeding
Symptoms that never occur with anal fissure: unintentional weight loss
Lower gastrointestinal 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.
Top Symptoms: rectal bleeding, severe rectal bleeding, moderate rectal bleeding
Urgency: Emergency medical service
Colonic neoplasm means "new tissue" growing in the colon, or large intestine. This neoplasm may be either benign (not cancerous) or malignant (cancer.)
The exact cause of any cancer remains unknown. Risk factors seem to be:
Being over fifty years of age.
- Family history of the disease.
- A high-fat, low-fiber diet, typical in the modern world
- Chronic inflammatory diseases of the colon such as Crohn's disease.
- Smoking and alcohol use.
- Diabetes, obesity, and inactivity.
The earliest symptoms are usually polyps, small growths within the colon which can be detected on colonoscopy and removed before they can become cancerous. Later symptoms may be unexplained fatigue; change in bowel habits; persistent abdominal discomfort such as gas or cramps; blood in stool; or rectal bleeding.
Diagnosis is made through colonoscopy and sometimes blood testing.
Treatment is done through surgery, which may be minor or extensive; and through chemotherapy with radiation therapy, usually done before and after surgery. Supportive care to keep the patient comfortable is also an important part of treatment.
Top Symptoms: fatigue, stomach bloating, stool changes, diarrhea, constipation
Urgency: Primary care doctor
Constipation is a very common condition affecting the large intestine. It is characterized by difficulty passing stool, or passing stool less often. Commonly it is linked to not eating enough dietary fiber, not drinking enough fluids, or not getting enough exercise. Some medications can cause constipation as well.
Top Symptoms: stomach bloating, constipation, abdominal cramps (stomach cramps), pain when passing stools, rectal bleeding
Symptoms that always occur with chronic constipation: constipation
Symptoms that never occur with chronic constipation: unintentional weight loss
Urgency: Primary care doctor
Intestinal inflammation (diverticulitis)
Diverticula are small pouches that bulge outward through the colon, or large intestine. Diverticulitis is a condition where the pouches become inflamed or infected, a process which can cause fever, nausea, vomiting, chills, cramping, and constipation.
Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, constipation
Symptoms that never occur with intestinal inflammation (diverticulitis): pain below the ribs, pain in the upper right abdomen
Urgency: Hospital emergency room
New onset crohn's disease
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)
Urgency: Primary care doctor
Diverticulosis is the common condition of small, sac-like pouches forming and pushing outward along the inside of the colon, called diverticula.
These symptoms should prompt a visit to a medical provider, since diverticulosis can lead to diverticulitis an inflammation of the pouches that can have serious complications.
Treatment involves a high-fiber diet, medicines to ease bloating and other symptoms, probiotics and sometimes antibiotics. Procedures to stop bleeding may be necessary as well as surgery to remove the problematic area of the colon.
Top Symptoms: stomach bloating, diarrhea, constipation, flatulence, incomplete evacuation of stools
Urgency: Primary care doctor
Rectal Bleeding Treatments and Relief
Seek immediate treatment in the emergency room or call 911 if:
- A significant amount of blood suddenly appears from the rectum, whether this happens during a bowel movement or not.
- You also have severe abdominal pain or cramping.
- You feel cold, nauseated, dizzy, or lightheaded, or actually faint, while symptoms of rectal bleeding are occurring. This may indicate that a large amount of blood is being lost internally .
Schedule an appointment for:
- Rectal bleeding that happens on a regular basis, even if there seems to be only a small amount of blood [2, 3, 9].
- Stools that appear, tarry, black, or maroon. These colors indicate larger amounts of blood being present .
- Bleeding that occurs on its own and not while you are having a bowel movement.
- Ongoing pain in the anus and rectum, often with mucus discharge.
Remedies that you can try at home:
- Easing constipation through improved diet and exercise, drinking more water, and taking an over-the-counter fiber supplement [6, 8, 9].
- Trying warm baths and over-the-counter hydrocortisone cream for the hemorrhoids.
FAQs About Rectal Bleeding
Here are some frequently asked questions about rectal bleeding.
Does rectal bleeding stop on its own?
Rectal bleeding (hematochezia) may stop on its own depending on the cause. A hemorrhoid or injury of the anus, like an anal tear, will usually stop bleeding on its own [7, 8, 9]. If you have rectal bleeding that has not been examined by a medical professional, you should seek examination and treatment.
Can rectal bleeding cause anemia?
Yes, bleeding from the rectum (hematochezia) can cause anemia if it is uncontrolled acutely or chronically. There are many causes of rectal bleeding, the most common are hemorrhoids and anal fissures, but cirrhosis or liver failure from alcohol can also increase the risk of bleeds as can diverticulosis or an outpouching of the colon .
Can rectal bleeding be caused by stress?
Generally no, rectal bleeding (hematochezia) is not caused by stress. Stomach ulcers can be caused by stress, but the enzymes and hormones that cause a stomach ulcer do not affect the rectum similarly . If you are experiencing rectal bleeding you should seek medical care.
Why does rectal bleeding occur after a bowel movement?
Rectal bleeding (hematochezia) may occur after a particularly large or hard bowel movement, especially if associated with straining, from an anal tear or anal fissure. Less commonly, stool that has an abrasive substance like nuts or undigested whole grains can tear the anal mucosa and cause bright red blood on the toilet paper or in the bowl.
Why does my rectal bleeding come and go?
Rectal bleeding (hematochezia) can come and go for a variety of reasons. It can be caused by hemorrhoids as well as anal fissures [8, 9], certain types of inflammatory bowel disease [16, 17, 18], deformations or changes of the rectum and cancers . Most of these causes can produce intermittent bleeding so you should seek medical evaluation to determine the cause. Intermittent bleeding is often caused by intermittent clotting or blockage of a bleed with firm stool.
Questions Your Doctor May Ask About Rectal Bleeding
To diagnose this condition, your doctor would likely ask the following questions:
- Have you had any changes in your weight?
- Do you have a history of constipation?
- Is your bleeding painful or painless?
- Have you ever been diagnosed with cancer?
The above questions are also covered by our A.I. Health Assistant.
If you've answered yes to one or more of these questions
Take a quiz to find out why you're having rectal bleeding
Rectal Bleeding Symptom Checker Statistics
People who have experienced rectal bleeding have also experienced:
- 11% Abdominal Pain (Stomach Ache)
- 8% Diarrhea
- 4% Nausea
People who have experienced rectal bleeding were most often matched with:
- 33% Hemorrhoids
- 33% Chronic Or Recurrent Hemorrhoids
- 33% Anal Fissure
People who have experienced rectal bleeding had symptoms persist for:
- 33% Less than a day
- 29% Over a month
- 23% Less than a week
Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).
- 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.