What Does Blood in Your Poop Mean?

It can be frightening to see blood in the toilet or when you wipe after you poop. Health's medical editor weighs in on some possible causes.

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Fortunately, most of the causes of rectal bleeding are not life-threatening, according to UpToDate. However, it's not possible to know the cause of bleeding without an examination by a clinician.

If you notice blood in your stool, take note of a few things:

  • How much blood do you see?
  • What is the color of the blood?
  • Is the blood mixed in with the stool or floating on top?

These are some details that can help a healthcare provider pinpoint the source of the bleeding.

It's important to bring any bloody stool concerns to the attention of a healthcare provider right away as blood in your stool can signal a wide range of causes, from hemorrhoids to cancer. Below are a few possible causes of blood in your stool:

Anal Fissures

If you notice bright red blood covering the surface of the stool, it means the bleeding is at or just above the anus, as per the International Foundation for Gastrointestinal Disorders (IFFGD). This symptom usually turns out to be a tear of the anus itself, called an anal fissure.

Anal fissures can cause bleeding and a sensation of tearing, ripping, or burning pain during or after a bowel movement. While they can be painful, the cuts are typically nothing to worry about and heal on their own within a few weeks.

Anal fissures that don't get better within six weeks may require medicine or surgery—but that's pretty rare.

Hemorrhoids

Blood on your poop, or bleeding during or between bathroom runs, could also be a sign of hemorrhoids. These are swollen blood vessels in the rectum or anus that can be painful, itchy, and sometimes bleed.

People with hemorrhoids often have painless rectal bleeding; bright red blood may coat the stool after a bowel movement, drip into the toilet, or stain toilet paper, according to UpToDate.

You can develop hemorrhoids from a variety of causes, according to MedlinePlus including:

  • Straining during bowel movements
  • Sitting on the toilet for long periods of time
  • Chronic constipation or diarrhea
  • A low-fiber diet
  • Weakening of the supporting tissues in your anus and rectum (this can happen with aging and pregnancy)
  • Frequently lifting heavy objects

Often hemorrhoids can be made less troublesome with dietary tweaks, like drinking plenty of water and adding fiber to help soften stools.

If you see a healthcare provider, they may suggest using a stool softener or an over-the-counter hydrocortisone cream to help with the swelling and itchiness.

IBD and Inflammation of the Digestive Tract

Blood in the stool can also be a sign of inflammatory bowel disease (IBD). The most common types of IBD are Crohn's disease, which involves inflammation anywhere in your digestive tract, and ulcerative colitis (UC), in which the inflammation specifically affects the lining of the colon and rectum.

According to the Crohn's and Colitis Foundation of America (CCFA) inflammation can cause small sores (ulcers) to form in the colon and rectum. These can join together and become large ulcers that bleed, resulting in bloody stools.

IBD can also cause abdominal pain, fever, and weight loss when it flares up. According to the CCFA, the lining of the intestine becomes inflamed and ulcerated, and it loses its ability to adequately process food and waste or absorb water, resulting in loose stools (diarrhea) and in severe cases weight loss.

Mild IBD symptoms can often be controlled by medication combined with the following measures:

  • Avoiding certain foods (including fatty and high-fiber kinds, as well as dairy)
  • Eating smaller and more frequent meals
  • Drinking plenty of water
  • Exercising

In extreme cases, treatment may include surgery or additional medications.

According to Crohn's and Colitis Canada, stool blood that is bright red is usually coming from the rectum or large intestine. Whereas darker or black stools could be due to blood higher up in the digestive system.

In ulcerative colitis, bleeding can start in the lining of the rectum or large intestine and generally comes from the ulcers that formed in the lining of the large intestine or rectum. This blood may end up in your stool.

In Crohn's disease, bleeding is less common. Bleeding depends on where the inflammation occurs. Crohn's disease in the colon (large intestine) or rectum is more likely to cause blood in or on the stool.

Cancer

Though most blood in your stool is caused by the reasons mentioned above, rectal bleeding can also be caused by cancerous or precancerous conditions, according to Medline Plus.

It's especially important to bring any bloody stool concerns to the attention of a healthcare provider right away because precancerous polyps near the end of the colon (large intestine) can mimic bleeding from hemorrhoids. These polyps are generally present in the colon for years before they become cancerous.

The good news is that they can be removed very safely from the colon, preventing progression to cancer.

Unfortunately, colorectal cancer is sometimes diagnosed in people who have ignored bleeding for years because they thought it was from hemorrhoids. However, if colorectal cancer is diagnosed early, it can often be treated.

Those with Crohn's disease and UC are also at higher risk of developing colon cancer.

When To See a Provider

Even if you think hemorrhoids are causing the blood in your stool, it's a good idea to see a healthcare provider.

According to Medline Plus, the following symptoms warrant a visit to a healthcare provider:

  • Fresh blood in your stools
  • A change in the color of your stools
  • Pain in the anal area while sitting or passing stools
  • Incontinence or lack of control over passage of stools
  • Unexplained weight loss
  • Drop in blood pressure that causes dizziness or fainting

A provider will ask about your medical history and perform a physical exam that will focus on your abdomen and rectum. They can work with you to help determine the best course of treatment.

Health's medical editor, Roshini Rajapaksa, MD, is an assistant professor of medicine at the NYU School of Medicine.

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