Blood in Stool? Here’s What It Could Mean

Blood in stool (rectal bleeding) means noticing blood on the toilet tissue when you wipe or seeing bloody stools in the toilet bowl after a bowel movement. The medical term for it is hematochezia.

GI bleeding can be a symptom of many different conditions, some of which are serious. If you notice blood in your stool, you should make an appointment to see your healthcare provider. In the meantime, keep reading to find out some of the possible causes of blood in your stool.

Is blood in stool serious?

Most rectal bleeding is not serious or life-threatening, for example, minor rectal bleeding due to hemorrhoids or anal fissures. However, gastrointestinal bleeding can be a sign of a more serious condition such as colorectal cancer. The only way to be sure is to see your healthcare provider. They will obtain a history, take into account your other symptoms (for example, severe abdominal pain or bloody diarrhea), perform a physical examination, order tests, make a diagnosis, and offer the appropriate treatment for your bloody bowel movements.

Is bright red blood in stool serious?

If you are experiencing rectal bleeding or GI bleeding, the appearance of the blood in your stool can provide a clue about the bleeding site in your digestive tract.

Bright red blood in stool or fresh blood on toilet paper usually indicates active bleeding in the lower GI tract (large intestine, rectum, or anus).
Maroon or darker blood typically originates higher up in the GI tract (intestinal bleeding in the small intestine or colon).
Black or tarry stools (medical term: melena) are indicative of acute bleeding in the upper GI tract, for example, from peptic ulcers in the stomach.

Sometimes, the blood in stool is not visible to the naked eye. This is called occult bleeding and is only identifiable by a stool test called the fecal occult blood test.

Note: Certain foods like beets, tomatoes, and cranberries, as well as red food coloring, can make your stools look red.

What does blood in the stool indicate?

Blood in your stool can indicate many different conditions of the digestive system, some of which are listed below:

Hemorrhoids

Also called piles, hemorrhoids are one of the most common causes of rectal bleeding. They are swollen veins in the rectum or anus that are present close to the surface of the skin. These swollen blood vessels are prone to breaking and bleeding when you strain during a bowel movement, lift heavy objects, or during pregnancy. Minor hemorrhoids do not usually require any treatment other than lifestyle modifications. However, in severe cases, abnormal blood vessels can be treated with procedures such as rubber band ligation, sclerotherapy, photocoagulation, electrocoagulation, hemorrhoidectomy, or hemorrhoid stapling.

Anal fissure

An anal fissure is a tear in the lining of the anus or lower rectum. It can cause bleeding and pain when you strain or pass a hard stool. Some anal fissures heal on their own, while others need treatment.

Bacterial infection

Food poisoning or bacterial infections such as E. coli or C. difficile can lead to bloody stool from hemorrhagic colitis (bleeding in the colon). Similarly, H. pylori infection can also cause rectal bleeding. Bacterial infections may resolve on their own or require antibiotics.

Inflammatory bowel disease

This is a condition in which there is chronic inflammation in the small intestine (ulcerative colitis) or large intestine (Crohn’s disease). Symptoms of inflammatory bowel disease include abdominal pain and diarrhea. Intestinal bleeding can be present in severe cases.

Diverticulitis

Diverticular disease is when small pouches called diverticula develop in the lining of the lower end of the colon near the rectum. Infection and inflammation of the diverticula can lead to a break in a blood vessel and acute bleeding.

Peptic ulcer disease

Peptic ulcers are sores in the stomach or duodenum (the first part of the small intestine) that form when stomach acid wears away the protective lining. Stomach ulcers can cause gnawing stomach pain and bleeding. They can be diagnosed with an imaging study called gastrointestinal endoscopy. The blood in your stool tends to be dark red in this case because of the action of digestive chemicals on the blood as it passes through the digestive tract. Black stools usually indicate a problem in the upper GI tract.

Colon polyps and colorectal cancer

Colon polyps are mushroom-like growths that can be benign or malignant. Malignant or cancerous polyps are more likely to bleed. If you have rectal bleeding, depending on your medical history and family history, your doctor may order a colonoscopy to rule out colon cancer.

Sexually transmitted infections

Certain sexually transmitted infections like chlamydia, gonorrhea, and syphilis can cause anal inflammation and bleeding. Herpes can cause sores, and human papillomavirus can cause anal warts that bleed. There are specific treatments for these infections, so it’s important to see your healthcare provider and obtain a proper diagnosis.

When should I be worried about blood in my stool (rectal bleeding)?

As mentioned above, rectal bleeding can be due to a minor cause, but it can also be a sign of something more serious. Therefore, it’s a good idea to have rectal bleeding checked out by your healthcare provider. However, if you have a known cause for rectal bleeding, such as hemorrhoids, you could try home remedies like increased fiber intake, hydration, and Sitz baths, to see if they provide relief.

It is especially important to see your doctor for rectal bleeding if:

You have no known gastrointestinal problem, and it’s the first time you’ve had rectal bleeding.
The bleeding is accompanied by other symptoms, such as stomach pain.
It has been going on for more than a week.
The bleeding is heavy or frequent.

You should go to the emergency room if you have sudden severe bleeding (gastrointestinal hemorrhage) because this can lead to significant blood loss. Seek emergency care to control bleeding if your rectal bleeding is accompanied by symptoms such as low blood pressure, lightheadedness, dizziness, fainting, tiredness, pale skin, or shortness of breath.

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