While bleeding from the rectum or anus can be surprising and uncomfortable, it usually indicates a minor issue, like an anal fissure (tear) or hemorrhoids. It can also be a sign of a serious underlying condition, however. Schedule an appointment with your doctor right away if you experience unexplained rectal bleeding. If the rectal bleeding is severe, accompanied by painful stomach cramps, or lasts for several days, it may be a sign of colon cancer. Your doctor will be able to perform an abdominal exam that determines the cause and the severity of the rectal bleeding.
Look for blood on your toilet paper.
Minor rectal bleeding will leave small drops or smears of blood on your toilet paper. If you’re experiencing bleeding from the anus itself, the blood will be bright red in color.
Anal bleeding while having a bowel movement may be caused by anal fissures or hemorrhoids. However, it can also be a sign of more serious conditions and should always be checked out by a doctor.
Look for blood in the toilet water.
If your rectal bleeding is slightly more severe, you may notice a pink, bloody color in the toilet water after a bowel movement. You may also see droplets of blood or thick, bloody clots in the water. At most, you’ll pass 1–2 teaspoons (4.9–9.9 mL) of blood into the toilet water.
Look for maroon or black colored stool.
Rectal bleeding isn’t always as apparent as blood-stained toilet paper. If the blood originated from several inches or centimeters up your rectum, it will have been absorbed into the stool. This can produce a variety of dark, uncommon colored stools. Black, tarry, or bloody stools, called melena, are always a cause for concern. If you notice this type of discoloration, especially over the course of a day or two, see your doctor right away.
Certain foods can also discolor your stools. A single instance of dark or maroon colored stool may not be enough to indicate rectal bleeding.
However, if you notice maroon or black stools for 2 or 3 days in a row, you can be reasonably confident that you’re experiencing internal bleeding in your rectum or higher up in your gastrointestinal tract.
Schedule an appointment if you experience rectal bleeding.
Any time you experience rectal bleeding, it is important to visit your doctor and have any serious causes ruled out or identified. Seek urgent medical care if:
Rectal bleeding is accompanied by a fever or nausea.
Your skin turns pale and sweaty while you are experiencing rectal bleeding.
You experience severe abdominal cramps.
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Ask your doctor about a rectal or stool exam.
As an initial test, your doctor may perform a digital and visual anal and rectal examination. The doctor will use a gloved finger to inspect your anus and lower rectum for trauma, hemorrhoids, or the presence of a foreign body.
The doctor may also feel and apply pressure to your abdomen externally. They’ll feel for any odd lumps or potential tumors inside your body.
Agree to provide stool or blood samples.
If the visual examination proves inconclusive, the doctor may request a sample of blood, stool, or both. A blood test will allow the doctor to determine how much blood you have lost and if your blood is able to clot adequately. The doctor or a nurse can draw the blood sample while you’re in the office.
Both the blood sample and stool sample will need to be sent to an off-site lab for examination. The results may take up to a week to be returned.
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Agree to receive a colonoscopy, if necessary.
In some cases, your doctor may decide that a colonoscopy is needed to determine the cause or location of your rectal bleeding. When performing a colonoscopy, the doctor will insert a flexible plastic tube with a camera attached into your rectum. This allows the doctor to have a clearer image of your rectum and will allow them to determine the cause of your rectal bleeding.
Instead of a colonoscopy, the doctor may prefer a different type of internal examination, including an endoscopy or flexible sigmoidoscopy.
If your doctor is able to see an obvious external source for the bleeding, such as hemorrhoids, you may not need to receive a colonoscopy. They may still recommend an internal examination to rule out cancer or other serious underlying causes, however.
If you’re 40 or older, your doctor will recommend a colonoscopy to rule out the possibility of colon cancer causing your rectal bleeding.
Take any prescribed medications as directed.
Your doctor may prescribe to you a number of different medications, depending on the specific causes of your rectal bleeding. These could include a stool softener, pain medication, an iron supplement to increase your body’s blood production, and a medication to constrict blood vessels and decrease bleeding.
If you have hemorrhoids, the doctor may also provide a hemorrhoid cream or a steroid cream to reduce rectal inflammation.
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Include more fiber in your diet.
A fiber-heavy diet can provide a long-term solution to occasional, minor rectal bleeding. Anal fissures are often caused by constipation or by excessive straining when defecating. If you frequently experience either of these conditions, adding fiber to your diet will help bowel movements pass more easily. Fibrous foods include:
Legumes like lentils, split peas, and chickpeas.
Fruits like pears and apples, with the skin on.
Whole-grain muffins, bagels, and pasta.
Drink enough water to keep your body hydrated.
When your body becomes dehydrated, it will produce firmer stools that are harder to pass. Anal fissures and mild rectal bleeding are a common consequence. Avoid this by staying hydrated so that your stools are easy to pass and do not damage your rectum or any hemorrhoids.
On average, an adult woman should drink about 11.5 cups (2.7 L) of water and other fluids a day. An adult man should drink about 15.5 cups (3.7 L) of water and other fluids a day.
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Wait for minor bleeding from fissures or hemorrhoids to stop on its own.
Most instances of rectal bleeding from anal fissures will stop on their own once your bowel movement is over. If you have seen the doctor and know that your bleeding is the result of a minor issue, such as a fissure or hemorrhoid, wait for the bleeding to stop or lightly blot your anus with toilet paper to stop the blood flow.
Apply an over-the-counter cream.
If rectal bleeding from hemorrhoids or anal fissures persists over 2 or 3 days, visit your local drugstore pharmacy for a hydrocortisone or hemorrhoid cream. The cream will decrease the discomfort or pain, and will help the sores or fissures stop bleeding and heal.
Consult your doctor before applying a medicated cream. Although most over-the-counter creams are mild and safe, your doctor will be able to advise you about which brand of cream to use.
The doctor can also write you a prescription if a stronger cream is needed.