What Is Rectal Bleeding? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Rectal bleeding, which is bleeding from the rectum or anus, is a scary but surprisingly common phenomenon.

Rectal bleeding is usually assumed to refer to bleeding from your rectum, which makes up the last few inches of your large intestine. Bleeding from higher in the intestinal tract, from the stomach, duodenum, or other parts of the small intestine, may also pass through the large intestine and appear to come from the rectum, notes MedlinePlus.

Signs and Symptoms of Rectal Bleeding

Blood from rectal bleeding ranges in color from bright red to maroon to black or tar colored. Blood can be on or in the stool, be combined with mucus in the stool, or appear on your clothes and underwear, on toilet paper, or in the toilet water.

Symptoms that commonly occur with serious rectal bleeding include:

  • Abdominal pain
  • Dizziness
  • Fatigue
  • Diarrhea
  • Constipation
  • Unintentional weight loss

Causes and Risk Factors of Rectal Bleeding

The most common causes of rectal bleeding are diverticulosis, hemorrhoids, anal fissures, and colitis, according to the Cleveland Clinic.

Diverticulosis is the most frequent cause of rectal bleeding. It is the presence of tiny bulges, called diverticula, in the colon wall. Diverticula are common and typically do not cause problems, but they can sometimes protrude through the walls of the bowels, leading to bleeding or infections.

Often called piles, hemorrhoids are swollen veins that appear at the bottom of the large intestine and outside the anus. They may be caused by excessive straining, such as while making a bowel movement, sitting on the toilet too long, or in women, pregnancy and giving birth. People who have persistent hemorrhoids are often constipated, are overweight or obese, or eat a very low-fiber diet.

Hemorrhoids can be itchy, painful, and annoying, but they are rarely serious and often go away on their own. In certain cases, treatment may be needed.

Anal fissures, another cause of rectal bleeding, are tiny tears in the anus and anal canal commonly caused by straining with hard stools.

Colitis is the inflammation of the lining of the tissues of the colon. This inflammation can lead to rectal bleeding. Ischemic colitis occurs when blood flow to the colon is reduced, typically as a result of narrowed or blocked arteries. With infectious colitis, the swelling of the colon is caused by bacteria, viruses, or parasites.

Less common causes of rectal bleeding include intestinal polyps, proctitis, colon cancer, inflammatory diseases of the bowel, or rapid bleeding from the stomach or upper GI tract.

Intestinal polyps are masses of tissue that protrude from the bowel wall, sometimes causing minor bleeding. Proctitis is an inflammation of the lining of the rectum. If you have proctitis, you may feel rectal pain and the continuous sensation of having to make a bowel movement.

Colorectal cancer is one of the most serious causes of rectal bleeding. Anal cancer, which is less common than colorectal cancer, can also cause rectal bleeding.

People with an inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, may also experience rectal bleeding and related symptoms, such as abdominal pain, diarrhea, constipation, ulcers, and a higher risk for colorectal cancers.

How Is Rectal Bleeding Diagnosed?

When you see a doctor for rectal bleeding, you’ll be asked a series of questions to help identify the cause. These can include when the rectal bleeding began, any foods you ate prior to the onset of symptoms, if you were constipated, and if you were straining during your bowel movement.

Your doctor will also perform a medical exam and take your medical history.

Tests that may help determine the cause of rectal bleeding include:

  • Colonoscopy, in which a long, flexible tube with a tiny camera on its tip is inserted into the rectum. This allows your doctor to view the inside of the entire colon and look for any abnormalities, notes the Mayo Clinic.

  • Sigmoidoscopy, in which a healthcare provider uses a sigmoidoscope, a flexible tube with a light and camera, to view the lower part of your colon and rectum. This test can help diagnose bowel disorders and cancer, per the Cleveland Clinic.

  • Fecal occult blood test, which is a lab test to detect hidden, or occult, blood in stool. The test can be done in a few ways, either by the patient collecting stool samples and returning them to their doctor or a lab or by using a flushable pad or tissue that changes color when blood is present, according to the Mayo Clinic.

Duration of Rectal Bleeding

How long rectal bleeding lasts will vary based on the individual and condition causing it.

Rectal bleeding from hemorrhoids can last anywhere from a few seconds to several minutes with bowel movements. Bleeding may also occur occasionally between bowel movements. Talk to your doctor if you have rectal bleeding or if you have hemorrhoids that don’t clear up after a week, notes the Mayo Clinic.

Anal fissures typically heal within a couple of weeks, according to the National Health Service in Great Britain.

Rectal bleeding associated with polyps or colorectal cancer may occur in small amounts over time until a doctor identifies the cause and treats it.

Treatment and Medication Options for Rectal Bleeding

If you are experiencing rectal bleeding, the first thing to do is try to identify the cause. The cause will determine any treatment you may seek.

For example, losing weight, consuming more fiber-rich foods, and taking over-the-counter treatments are usually effective at managing the symptoms of hemorrhoids, according to the Mayo Clinic.

Anal fissures can usually be managed with treatment for constipation and the use of moistened wipes, which soothe the area around the anus. Anal fissures rarely require medical treatment or surgery, notes the Mayo Clinic.

More serious causes of rectal bleeding, such as bowel disease or cancer, may require more advanced treatment. People living with Crohn’s disease, for instance, may be prescribed medications like corticosteroids or immunotherapy. Those with cancer may require surgery to remove tumors, per the Cleveland Clinic.

Prevention of Rectal Bleeding

The best way to prevent rectal bleeding is to prevent its chief causes.

To prevent hemorrhoids, it’s important to keep your stools soft so they can pass easily. To do this, drink plenty of fluids and eat a diet high in fiber. Go to the bathroom as soon as you feel the urge and avoid straining when passing stools. Also, limit your time sitting on the toilet.

Anal fissures can be prevented by avoiding irritating the rectum and wiping the area with soft tissues, a moistened cloth, or cotton pad. Don’t use rough or scented toilet paper.

People at an increased risk for colorectal cancer should undergo regular screenings, primarily colonoscopy. Colorectal cancer screenings can detect precancerous polyps in the colon or rectum so that they can be removed before they turn into cancer. Screenings can also identify colorectal cancer early, when treatment is more likely to be successful.

According to the Centers for Disease Control and Prevention (CDC), about 90 percent of new cases of colorectal cancer occur in people over age 50. Therefore, the U.S. Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer. How often you undergo screening is determined by your risk and should be discussed with your doctor. Adults age 76 to 85 should talk to their physician about whether they should continue to be screened, the CDC says.

Lifestyle changes can also help reduce the risk of colorectal cancer, including quitting smoking, maintaining a healthy weight, getting regular physical activity, and limiting red meat consumption and alcohol use, according to the American Cancer Society (ACS).

According to the 2020–2025 U.S. Dietary Guidelines for Americans, if alcohol is consumed, it should be done in moderation, meaning up to one drink per day for women and up to two drinks per day for men.

Complications of Rectal Bleeding

Light rectal bleeding or spotting due to constipation or hemorrhoids in people under 40 rarely needs medical attention. However, if your rectal bleeding is continuous or heavy, it could lead to shock, a life-threatening condition in which the body is not getting enough blood flow. If not treated, this can result in organ damage. According to the Mayo Clinic, you should seek medical attention immediately if you are experiencing rectal bleeding and any of the signs of shock, including:

  • Faintness
  • Nausea
  • Rapid, shallow breathing
  • Blurred vision
  • Dizziness or lightheadedness
  • Confusion
  • Clammy, pale skin
  • Low urine output

Untreated polyps in the colon or rectum that cause rectal bleeding can lead to colorectal cancer.

Research and Statistics: How Many People Have Rectal Bleeding?

While no statistics exist stating exactly how many people are affected by rectal bleeding at any given time, research suggests that it’s a common enough occurrence.

A study published in the British Journal of General Practice found that the consultation rate for rectal bleeding in patients over age 34 was 15 per 1,000 per year.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, hemorrhoids, a major cause of rectal bleeding, affect about 1 in 20 adults in the United States. About half of adults over age 50 have hemorrhoids.

About 1 in 10 people are affected by anal fissures at some point in their lives.

According to the ACS, excluding skin cancers, colorectal cancer is the third most common cancer diagnosis in the United States. In 2020, the ACS estimates that there were 104,610 new cases of colon cancer and 43,340 new cases of rectal cancer.

Black Americans and Rectal Bleeding

While there are no statistics on rectal bleeding in different ethnic groups, colorectal cancer disproportionately affects the Black American community. According to the ACS, Black Americans are 20 percent more likely to receive a colorectal cancer diagnosis and are 40 percent more likely to die from it than people in other groups.

While the reasons for this disparity are complex, they reflect racial differences in risk factors, access to healthcare, and socioeconomic status. Black Americans have higher rates of obesity, with non-Hispanic Black Americans about 1.3 times more likely to be obese compared with non-Hispanic white Americans, the U.S. Department of Health and Human Services Office of Minority Health reports.

Black Americans also experience greater obstacles to cancer prevention, detection, treatment, and survival. Such obstacles include lower paying jobs, lack of health insurance, lack of access to healthy and affordable foods, and low-quality housing and education.

Related Conditions and Causes of Rectal Bleeding

Colorectal cancer is one of the most serious causes of rectal bleeding. It is the third leading cause of cancer-related death in men and women, although death rates are dropping, thanks to earlier detection.

When cancer develops in a polyp, it can grow into the wall of the colon or rectum over time. From there, the cancer can grow into blood vessels or lymph nodes and can spread to nearby lymph nodes or different parts of the body. Screening for polyps is key to preventing colorectal cancer or catching it early so it can be treated, notes the ACS.

Anal cancer is an uncommon type of cancer occurring in the anal canal that can cause rectal bleeding. According to the ACS, there were an estimated 8,590 new cases of anal cancer in 2020 and 1,350 deaths.

?Most people with anal cancer are treated with chemotherapy and radiation. This type of cancer rarely spreads to different parts of the body. As such, many patients with anal cancer can be cured, notes the Mayo Clinic.

Common Questions & Answers

What are the symptoms of rectal bleeding?
Serious cases of rectal bleeding may involve abdominal pain, diarrhea, fatigue, constipation, and unintentional weight loss. The blood can show up in stool or mucus in stool, or you may see it on underwear, on toilet paper, or in toilet water.
What are common causes of rectal bleeding?
Rectal bleeding is most often caused by hemorrhoids and anal fissures. Diverticulitis, a condition in which tiny bulges appear on the colon wall, and colitis, which is the inflammation of the lining of the colon, may also be causes.
How serious is rectal bleeding?
Rectal bleeding is a scary but common phenomenon. Typical causes like hemorrhoids or anal fissures?aren’t life threatening, but in some cases, rectal bleeding can be a sign of colon cancer or, more rarely, anal cancer.
Is rectal bleeding bright red?
Blood from rectal bleeding ranges in color from bright red to maroon to black or tar-colored.
When should you worry about rectal bleeding?
Light rectal bleeding caused by constipation or hemorrhoids rarely needs medical attention. If the bleeding doesn’t stop after a week, check with your doctor. Bleeding due to colorectal cancer may occur in small amounts over time, so also check with your doctor if you notice this pattern.

Resources We Trust

  • Mayo Clinic:?Rectal Bleeding
  • Cleveland Clinic:?Rectal Bleeding
  • National Health Service: Anal Fissure
  • American Cancer Society:?Colorectal Cancer Risk Factors
  • U.S. Department of Health and Human Services Office of Minority Health: Obesity and African Americans
Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. Gastrointestinal Bleeding. MedlinePlus.
  2. Rectal Bleeding. Cleveland Clinic.
  3. Colonoscopy. Mayo Clinic.
  4. Sigmoidoscopy. Cleveland Clinic.
  5. Fecal Occult Blood Test. Mayo Clinic.
  6. Hemorrhoids: Symptoms and Causes. Mayo Clinic.
  7. Anal Fissure. National Health Service.
  8. Hemorrhoids: Diagnosis and Treatment. Mayo Clinic.
  9. Anal Fissure: Diagnosis and Treatment. Mayo Clinic.
  10. Anal Fissures. Cleveland Clinic.
  11. What Should I Know About Screening? Centers for Disease Control and Prevention.
  12. Colorectal Cancer Risk Factors. American Cancer Society.
  13. Dietary Guidelines for Alcohol. Centers for Disease Control and Prevention.
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  16. Definition and Facts of Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases.
  17. Key Statistics for Colorectal Cancer. American Cancer Society.
  18. Colorectal Cancer Rates Higher in African Americans, Rising in Younger People. American Cancer Society.
  19. Obesity and African Americans. U.S. Department of Health and Human Services Office of Minority Health.
  20. What Is Colorectal Cancer? American Cancer Society.
  21. Key Statistics for Anal Cancer. American Cancer Society.
  22. Anal Cancer: Symptoms and Causes. Mayo Clinic.

Resources

  • Gastrointestinal Bleeding. MedlinePlus. May 4, 2016.
  • Rectal Bleeding. Cleveland Clinic. August 13, 2020.
  • Colonoscopy. Mayo Clinic. May 18, 2022.
  • Flexible Sigmoidoscopy. Cleveland Clinic. October 19, 2020.
  • Fecal Occult Blood Test. Mayo Clinic. May 4, 2022.
  • Hemorrhoids: Symptoms and Causes. Mayo Clinic. May 12, 2021.
  • Anal Fissure. National Health Service. November 9, 2021.
  • Hemorrhoids: Diagnosis and Treatment. Mayo Clinic.?May 12, 2021.
  • Anal Fissure: Diagnosis and Treatment. Mayo Clinic. November 17, 2020.
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  • Colorectal Cancer Risk Factors. American Cancer Society. June 29, 2020.
  • Dietary Guidelines for Alcohol. Centers for Disease Control and Prevention. April 19, 2022.
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  • Definition and Facts of Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. October 2016.
  • Key Statistics for Colorectal Cancer. American Cancer Society. October 31, 2022.
  • Colorectal Cancer Rates Higher in African Americans, Rising in Younger People. American Cancer Society. September 3, 2020.
  • Obesity and African Americans. U.S. Department of Health and Human Services Office of Minority Health. March 26, 2020.
  • What Is Colorectal Cancer? American Cancer Society. June 29, 2020.
  • Key Statistics for Anal Cancer. American Cancer Society. January 12, 2022.
  • Anal Cancer Symptoms and Causes. Mayo Clinic. August 12, 2021.
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