Bright red blood on or in a bowel movement, on toilet tissue after wiping, or in toilet bowl water is a sign of rectal bleeding. It is a common problem for adults of all ages.
If you have bleeding, see your healthcare provider to make sure it is not a symptom of serious disease. Even though itâ€™s a common problem, rectal bleeding is not normal. If you are bleeding a lot or the bleeding doesnâ€™t stop, you should seek emergency care.
What is the cause?
There are many causes of rectal bleeding. The most common causes are anal fissures, hemorrhoids, and diverticula.
Anal fissures are tiny tears, usually less than 1/2 inch long, in the skin of the anus. The anus is the opening where bowel movements pass out of your body. Fissures are usually caused by constipation. Hard bowel movements tear the skin as they pass through the anus.
Hemorrhoids are swollen veins in the lower rectum and anus. The rectum is the end of the intestines just inside the anus. If there is too much pressure on the veins around the rectum and anus, you may get hemorrhoids. Hemorrhoids are also usually caused by constipation.
Diverticula are fingerlike pouches at weak points in the wall of the intestines. Bowel movements can get caught in the pouches. The pouches may get irritated or infected and bleed. Diverticula in the colon are a fairly common cause of rectal bleeding in middle-aged and older adults.
Other less common causes of rectal bleeding are:
Infection in the intestines, which can cause bloody diarrhea that usually lasts for 1 to 3 days.
Inflammatory bowel disease, which is irritation of the lining of the intestines. It causes pain in your belly, diarrhea, and mucus in your bowel movements as well as bleeding.
Diseases or injury in the upper digestive system, such as an ulcer that has damaged your stomach or intestines. The blood that comes from the upper digestive system may look like coffee grounds.
Colon cancer is not a common cause of blood that you can see. Itâ€™s more common for colon cancer to cause blood in the bowel movement that cannot be seen. Special tests of the bowel movement are usually needed to find blood caused by cancer.
What are the symptoms?
In addition to blood that you can see, you may have other symptoms. For example:
Hemorrhoids may cause pain when you sit.
Anal fissures may cause pain as your skin stretches when you have a bowel movement.
If you have diverticula, you may have no symptoms or you may have bouts of pain in your belly. Sometimes you may have pain with fever for a day or two if the diverticula are inflamed or infected.
If you have colon cancer that does cause bleeding you can see, it may be your only symptom or you may have other symptoms such as:
Unexpected weight loss
Feeling tired all the time
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:
Tests of a sample of bowel movement
Rectal and abdominal exam, which your provider does by gently putting a lubricated and gloved finger in your rectum. Your provider may also place his or her hand on your belly to feel and check the size and shape of your organs.
Anoscopy, which uses a small, lighted tube put into your rectum to look for internal hemorrhoids or other causes of bleeding
CT scan, which uses X-rays and a computer to show detailed pictures of the rectal area
MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the rectal area
Angiogram, which is a series of X-rays taken after your healthcare provider injects a special dye into your blood vessels to look for areas of bleeding
An ultrasound, which uses sound waves to show pictures of the rectal area
Sigmoidoscopy or colonoscopy, which uses a thin, flexible tube and tiny camera put into the rectum and up into the colon to look for causes of the bleeding. A sigmoidoscopy looks only at the lower part of the colon. A colonoscopy examines all of the colon. Sometimes pieces of tissue may be removed to help make a diagnosis. This is called a biopsy.
Barium enema, which is an X-ray taken of the belly after barium is inserted through the rectum to show the walls of the intestine and any possible problems. Barium is a liquid that helps your intestines show up well on the X-ray.
How is it treated?
The treatment for rectal bleeding depends on the cause. For simple problems such as fissures and hemorrhoids, you may need to increase the fiber in your diet and make other lifestyle changes to prevent constipation. Your healthcare provider will discuss with you other treatments if something else is causing rectal bleeding.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent rectal bleeding?
Try to keep your intestines as healthy as possible:
Eat a healthy diet with lots of high-fiber foods, such as whole grains, fresh fruits and vegetables.
Drink plenty of fluids.
Get regular exercise.
Try to keep a healthy weight. If you are overweight, lose weight.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2013-10-18 Last reviewed: 2013-10-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.