Rectal Bleeding

Is this your symptom?

• Blood in or on a passed stool; or blood that passes from the rectum (with no stool)
• Blood in the stools is often bright red, but bleeding from the stomach comes out tar-black or purple

Causes of Blood in Stools

• Anal Fissure or Tear is a common cause of rectal pain and blood in the stools. It causes blood on the surface of a stool. Blood may also be found on toilet tissue after wiping. The blood is always bright red and usually only a few streaks are seen. The tear is often caused by passing a large or hard stool. It can also be due to Crohn's disease, anal sex or happen with childbirth. It is less common with anal cancer or HIV. It can happen long-term and make passing stools painful. Pain may persist for several hours after passing a BM. Seek care if the fissure does not get better with the care advice.
• Hemorrhoid is a swollen vein in or near the anus. Around 75% of adults will have hemorrhoids at some time in their life. They cause bleeding, pain, and itching. Sometimes swelling or a lump at the anus occur. Bleeding is usually painless and happens with a BM. It is seen as a streak of blood on the toilet paper. Causes include constipation and straining to pass stools, sitting for long periods on the toilet, pregnancy, chronic diarrhea, obesity, regular heavy lifting and anal sex.
• Proctitis is inflammation of the lining of the rectum. It often occurs with inflammation in other parts of the bowel (Crohn's disease or ulcerative colitis). It causes pain, discharge and bleeding. It can also happen with radiation treatment for cancer in a different part of the body.
• Bowel Polyps may be a small single polyp or groups of polyps that grow in the bowel. Many are harmless and do not cause symptoms, but they can cause bleeding that is seen in stools or in the toilet bowl. Some polyps can become cancerous. A bowel exam with an endoscope (a camera that is passed into the rectum to examine the bowel lining) will help find polyps. The polyps can then be removed and tested for cancer.
• Colo Rectal Cancer tends to occur in older adults, but can occur at any age. Often starts as a polyp in the colon or in the rectum. The main symptoms to watch for are:
  • Blood in the stools
  • Change in your bowel habits, such as constipation or diarrhea which is new for you
  • Abdominal pain, cramps or gas
  • Feeling like your bowel does not empty fully
  • Feeling tired and lacking energy
  • Anemia
  • Weight loss for no clear reason (you have not been trying to lose weight)
  • Caution: you may have less serious rectal problems, but if bleeding is severe or there are frequent or repeated episodes, do not assume it is due to that problem. Your doctor can examine you and order tests. If you have a family history of colon cancer, you may be get screening tests to detect any polyps at an early stage.
• Inflammatory Bowel Diseases such as Crohn's Disease and ulcerative colitis are from inflammation in the bowel. They are long-term problems that can be hard to diagnose without a bowel exam. Both can cause bleeding from the bowel, abdominal pain, weight loss and diarrhea. Symptoms can be mild to severe.
• Peptic Ulcer and Duodenal Ulcer are open sores or ulcers that happen in the stomach or bowel. The main symptom is often pain in the upper part of the abdomen or the back. Sometimes the ulcer can bleed. With a bleeding stomach ulcer, you may vomit blood. The amount of blood can be slight (blood might look brown) or a large amount of blood (which is bright red). If you vomit bright red blood, Call 911 Now. Bleeding from an ulcer can be painless and you only know it is happening because of blood in your stools. Stool blood may look black or purple. It often will smell bad. If your stools look black, purple or are tarry, call you doctor or seek help now.
• Intestinal Ischemia (serious) can affect any part of the bowel. It occurs when the blood flow to part of the bowel is cut off due to blockage of the blood vessels or twisting of the bowel. There will be sudden onset of severe pain. There may be abdominal bloating, vomiting and bleeding from the rectum. Call 911 if you have these symptoms.
• Injury to the Abdomen can cause damage and bleeding into the bowel. Call your doctor or seek help now.
• Blood Clotting Disorders can cause bleeding from small blood vessels for no clear reason. You may bruise easily and you could see blood in your urine or stools. You may know you have a clotting disorder, or these symptoms might be the first sign that you have a problem. Call you doctor or seek help now if you have these symptoms.
• Bloody Diarrhea can occur with inflammatory bowel disease or can be caused by infection in the bowel. See the Diarrhea care guide for more detail.

Note: blood spreads quickly in water. Passing a stool with a few blood streaks often turns the toilet water pink. It doesn't mean a large blood loss.

Causes of Red Stools, but not Blood

Foods and meds can also cause red-colored stools that look like blood. Examples are:

• Certain foods (such as tomatoes or beets)
• Certain drinks (such as red Kool-Aid)
• Certain medicines (such as amoxicillin or omnicef)