Possible Causes of Bloody Stool

Fortunately, new drugs are reducing the number of IBD patients who need surgery.

Rectal Bleeding

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.

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Overview

Rectal Bleeding

What is rectal bleeding?

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.

• Bright red blood usually means bleeding that’s low in your colon or rectum.
• Dark red or maroon blood can mean that you have bleeding higher in the colon or in the small bowel.
• Melena (dark and tar-like stool) often points to bleeding in the stomach, such as bleeding from ulcers.

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.

Is rectal bleeding serious?

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.

How does rectal bleeding appear?

You might see or experience rectal bleeding in a few different ways, including:

• Seeing blood on your toilet paper when you wipe.
• Seeing blood in the bowl of the toilet when you are using the bathroom — the water in the bowl might look like it’s been dyed red.
• Noticing dark red, black or tarry poop while you are having a bowel movement.

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.

How would my stool look if I had rectal 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.

What are the symptoms of rectal bleeding?

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:

• Feeling rectal pain and/or pressure.
• Seeing bright red blood in or on your stool, underwear, toilet paper or in the toilet bowl.
• Having stool that’s red, maroon or black in color.
• Having stool that has a tar-like appearance.
• Experiencing mental confusion.
• Feeling lightheaded or dizzy.
• Fainting.

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:

• Experiencing a sudden drop in your blood pressure.
• Having a fast heart rate.
• Not being able to urinate.
• Slipping into unconsciousness.

Possible Causes

What causes rectal bleeding?

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:

• Hemorrhoids: The most common cause of rectal bleeding, hemorrhoids are swollen veins in the rectum (internal hemorrhoids) or the anus (external hemorrhoids). You can develop hemorrhoids for many reasons, including chronic constipation, straining during bowel movements, pregnancy, lifting heavy objects, having anal intercourse and having a higher body weight (obesity). Hemorrhoids aren’t a medical emergency and the blood you may see on your toilet paper or in the toilet bowel isn’t something to be majorly concerned about.
• Anal fissure: Sometimes confused for a hemorrhoid, an anal fissure is a split or tear in the skin around the anus. This happens when you have very hard stool that’s difficult to pass. The extra pressure of the bowel movement causes the skin to split open. An anal fissure can cause you to see blood when you go to the bathroom, as well as feel burning during bowel movements. Anal fissures usually go away on their own over time.
• Anal abscess or fistula: There are actually small glands inside your anus that are meant to help you pass stool. These glands can become infected causing abscesses or fistulas. When the gland inside the anus builds up puss, causing a blockage, it’s an abscess. An anal fistula is a tiny tunnel that connects the abscess to the skin around the anus. These conditions can be caused by inflammatory bowel disease, tuberculosis or radiation treatments.
• Diverticulosis/Diverticulitis: These conditions happen when small pouches — called diverticuli — develop in weakened sections of your intestine. These diverticuli can protrude through the walls of your bowels, causing bleeding and infections. When these pouches get infected, they can cause symptoms like abdominal pain, fever and a sudden change in bowel habits.
• Inflammatory bowel disease (IBD): Inflammatory bowel disease (IBD) is swelling of the small or large intestine. There are two types of IBD — crohn’s disease and colitis. Crohn’s disease is a condition where you develop patches of swelling in the digestive tract. In colitis, the swelling is mainly in the large bowel. People with IBD might experience fever, diarrhea, abdominal pain and cramping, intestinal blockages, and rectal bleeding.
• Ulcers: When the amount of digestive fluids in your intestines is out of balance, it can damage the lining of your digestive tract and cause ulcers. These can bleed, causing you to have black stool that’s sometimes tar-like in appearance.
• Largepolyps: A polyp can look like a mushroom that’s growing out of the side of your bowel. Large polyps can bleed, causing you to experience rectal bleeding. In some cases, polyps can turn into cancer if left untreated. It’s important to have rectal bleeding related to polyps checked because it could be a sign of colorectal cancer.

Are there any foods that can change the color of my stool in a similar way to rectal bleeding?

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.

Can straining too hard for a bowel movement cause rectal bleeding?

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.

Care and Treatment

Are there any tests for rectal bleeding?

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:

• When did the rectal bleeding start?
• What did you eat the day before seeing the rectal bleeding?
• How frequently do you have a bowel movement?
• Have you been constipated?
• Were you straining during your bowel movement?
• Do you have pain when you have the rectal bleeding?
• Is there blood on your stool (and what does that look like), in the toilet bowel or when you wipe?
• Do you have hemorrhoids?
• Do you have any inflammatory bowel conditions?
• Do you have a family history of colorectal cancer?

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:

• A physical exam of the rectum and anus.
• A colonoscopy.
• A sigmoidoscopy.
• A fecal occult blood test.

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.

Is bright red blood in my stool worse than darker blood?

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.

How do I treat rectal bleeding?

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.

Will rectal bleeding go away on its own?

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.

When to Call the Doctor

When do I need to see a doctor about rectal bleeding?

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.

What questions should I ask my doctor about rectal bleeding during an appointment?

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.

References

• 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.

Possible Causes of Bloody Stool

Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news.

Updated on October 10, 2022

Jay Yepuri, MD, MS, is a board-certified gastroenterologist and a practicing partner at Digestive Health Associates of Texas (DHAT).

Table of Contents
Table of Contents

Blood in the stool is there because of bleeding somewhere in the gastrointestinal (GI) tract. This can be due to many causes, including peptic ulcer disease, anal fissures, hemorrhoids, and several other medical conditions.

Blood in the stool usually looks blood-red or maroonish. Blood that comes from the upper GI tract and is digested as it moves through the gut may be black and tar-like.

Because blood in the stool may be a symptom of something serious, like cancer, it should never be ignored. Always see a doctor if you find blood in your stool. A physical exam, lab tests, and details from your personal history can help a doctor find the cause.

This article discusses some of the possible reasons for blood in the stool.

Verywell / Laura Porter

Upper GI Bleed

Blood in your stool may come from the upper GI tract. The most common cause of this is peptic ulcer disease. Ulcers are sores in the lining of the stomach or upper intestine. Blood from a peptic ulcer can be red or it can be black and tarry.

An upper GI bleed can be diagnosed with an endoscopy. During this procedure, a gastroenterologist looks at your upper GI tract with a camera attached to a narrow, flexible tube. The tube is passed down your throat to your gut.

If you have serious upper GI bleeding, you will need surgery.

Anal Fissure

Anal fissures are the most common cause of bloody stool in infants, but adults can get them too. The blood from anal fissures is bright red in color.

Anal fissures are caused by constipation, or large, firm stools that are hard to pass. This can cause a crack in the skin. Stretching the skin of the anus makes fissures visible.

Fortunately, anal fissures usually heal on their own. You can treat the pain and discomfort with petroleum jelly. Drinking more water and eating high-fiber foods can help soften your stools.

Polyps

A polyp is a small growth on the lining of your intestinal tract. There are a few different types of polyps. Adenomatous polyps are some of the most common. These polyps grow on the lining of the colon, or large intestine. About 25% of adults aged 50 and over have this type of polyp.

Adenomatous polyps can develop into colorectal cancer, or cancer of the colon or rectum. Colorectal cancer is the third most common cause of cancer-related deaths in the United States.

Although most cases of colorectal cancer develop from adenomatous polyps, only around 5% of polyps will become cancerous.

Polyps often have no symptoms, but sometimes they can cause bloody stools. The blood can be red or dark and tarry.

Polyps can be removed before they become cancerous. If they do progress to cancer, the cancer is treatable if caught early. That is why all people age 45 and older should be regularly screened for colorectal cancer. This can be done with a colonoscopy or stool-based test.

Hemorrhoids

Hemorrhoids are swollen blood vessels that can bulge from the anus. Hemorrhoids are often uncomfortable. They can be painful or itch. Because there are a lot of blood vessels around the anus and rectum, hemorrhoids may bleed bright, red blood.

You may be at risk for hemorrhoids if you:

• Have chronic diarrhea
• Are frequently constipated
• Do a lot of heavy lifting
• Sit for long periods of time
• Are pregnant

Surgery is an option if your hemorrhoids are severe, but most hemorrhoids do not require surgery. Eating more fiber or using a salve like Preparation H can help.

Gastroenteritis

Gastroenteritis is an illness of the stomach and intestines. It can be caused by a virus, bacteria, or parasite. Sometimes, gastroenteritis can cause bloody diarrhea. This is more common in bacterial gastroenteritis.

Food poisoning is a type of gastroenteritis. Bacteria that commonly cause food poisoning include:

Most of the time, gastroenteritis gets better on its own, but see a doctor if your symptoms last for more than one or two days.

Angiodysplasia

Bloody stool that can’t be explained is often caused by angiodysplasia. Angiodysplasia can happen as the blood vessels in the gut age or weaken. This type of bleeding can be red or dark and tarry.

Angiodysplasia is common during end-stage renal disease (kidney disease) or renal failure. People with a common genetic bleeding disorder called von Willebrand disease may also have angiodysplasia.

Angiodysplasia can be treated in a few different ways, including:

• Removal during endoscopy
• Hormone therapy
• Blood transfusions
• Iron supplements.

Fortunately, in most people, angiodysplasia disappears on its own.

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is an autoimmune disease of the bowels. When you have an autoimmune disease, your immune system attacks part of your own body. In IBD, this leads to inflammation and damage of the intestines.

Crohn’s disease and ulcerative colitis are the two most common types of IBD. Symptoms can include bloody stool, which may be red or dark and tarry.

IBD can be treated in a few different ways:

• Steroids
• Immune-modifying agents
• Surgery

Fortunately, new drugs are reducing the number of IBD patients who need surgery.

Cancer

Because blood in the stool may be a symptom of colorectal cancer, it is important to see a doctor if you notice this symptom. Bleeding from colorectal cancer may be red or dark and tarry.

Colorectal cancer was once thought to mostly affect people over the age of 50. Recent research, however, found that this cancer is also the third leading cause of cancer-related death in adults younger than 50.

There is good news, though. Thanks to earlier detection and treatment, the five-year survival rate for patients with colorectal cancer has been steadily increasing over time.

Diverticular Disease

Diverticula are abnormal pouches that can form in your lower intestine. There are two types of diverticular disease.

The simple presence of diverticula is called diverticulosis. Sometimes, though, diverticula become infected or inflamed. When that happens, the disease is called diverticulitis.

Both forms of diverticular disease can cause pain and blood in the stool. When diverticular disease causes bleeding, it will usually appear suddenly and be red or maroon in color.

Diverticula grow out of weaknesses in the wall of your colon. Sometimes they can grow to be several centimeters in size. The disease is often blamed on a low-fiber diet, but the true cause of diverticulitis is unknown.

A surgeon can stop bleeding from diverticula during an endoscopy or abdominal surgery. Diverticula can be treated in or out of a hospital. Diverticulitis can often be successfully treated with antibiotics.

Ischemic Colitis

Ischemic colitis happens when the blood vessels that supply the large intestine are narrowed or blocked. Most cases of ischemic colitis happen in elderly people. The condition can be short-term or long-term. Symptoms include:

• Red blood in the stool
• Diarrhea
• An urgent need to defecate
• Abdominal pain and vomiting

Most cases of ischemic colitis last a short time and resolve on their own. Sometimes, though, people with severe cases of ischemic colitis need to be hospitalized. Patients with severe disease may need intravenous (IV) fluids, antibiotics, and bowel rest, or a restricted diet.

About 20% of people who develop ischemic colitis end up needing surgery. Unfortunately, surgery for ischemic colitis is very dangerous. Up to 65% of patients who have this surgery will die.

False Alarm

Sometimes, what looks like bloody stool is really just coloring from something you’ve eaten. Dyes used in some fruit punch and gelatin can make your stool red. Beets may do the same thing.

Summary

It is important to see a healthcare provider if you find blood in your stool. Blood in the stool can have a number of causes.

Hemorrhoids and anal fissures are annoying and painful, but not harmful. Some causes of gastrointestinal bleeding may require surgery, including upper GI bleeds, polyps, angiodysplasia, inflammatory bowel disease, diverticular disease, and ischemic colitis.

Sometimes, blood in the stool can be a symptom of something serious, like cancer. Blood in the stool may also be a false alarm.

Frequently Asked Questions

What does blood in your stool mean for a woman?

• Ulcers
• Polyps
• Hemorrhoids
• Inflammatory bowel disease
• Many other causes

When should I be concerned about blood in my stool?

Anytime there is blood in the stool, you should have it checked out by your healthcare provider. Blood in the stool occurs when there is bleeding somewhere in the gastrointestinal tract. This can be a sign of something serious, like cancer, and should not be ignored.

What can cause blood in your poop?

Blood in the stool is caused by bleeding in the gastrointestinal tract. The GI tract is a series of hollow organs that includes the mouth, esophagus, stomach, small intestine, large intestine, and anus. Blood in the stool can look different depending on where the bleed is. A bleed in the upper GI tract will be digested as it moves through the gut and be more like black tar. Lower GI bleeds can range in shade from blood-red to maroon. A GI bleed can be caused by anal fissure, cancer, diverticulitis, a GI infection, hemorrhoids, inflammatory bowel disease, polyps, or an ulcer.

What can be mistaken for blood in the stool?

Red foods and red food coloring can be confused for blood in the stool. This includes licorice, beets, dark berries, red gelatin, and items made with red food coloring, like cake icing or fruit punch.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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Additional Reading

• Bullard Dunn KM, Rothenberger DA. Colon, Rectum, and Anus. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Schwartz’s Principles of Surgery, 10e. New York, NY: McGraw-Hill; 2014.
• Mayer RJ. Chapter 91. Gastrointestinal Tract Cancer. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.
• Stephan M, Carter C, Ashfaq S. Chapter 50. Pediatric Emergencies. In: Stone C, Humphries RL. eds. CURRENT Diagnosis & Treatment Emergency Medicine, 7e. New York, NY: McGraw-Hill; 2011.
• Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. Chapter 66. Hemorrhoids. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. eds. The Color Atlas of Family Medicine, 2e. New York, NY: McGraw-Hill; 2013.

By Naveed Saleh, MD, MS
Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news.