If you finish going to the bathroom and notice a small amount of bright-red to black blood in the toilet bowl, on 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.
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. The color of your stool 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:
- feeling dizzy
- rectal pain
Rectal bleeding causes 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:
- anal cancer
- colon cancer
- inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis
- intestinal infection, or infections caused by bacteria, such as salmonella
Less common rectal bleeding causes include blood-clotting disorders and allergic reactions to certain food types.
Severe rectal bleeding can constitute a medical emergency. Go to an emergency room if you experience the following additional symptoms:
- cold, clammy skin
- continuous rectal bleeding
- 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.
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 must 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 endoscopy 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 endoscopy procedures to view rectal bleeding include sigmoidoscopy or a colonoscopy.
A doctor may also order a blood test, such as a complete blood count to determine if you have lost a significant amount of blood.
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 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. Ulcers and infections can require antibiotic therapy to reduce infection-causing 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 hydrated