A Patient’s Story
Mark, 52, noticed bright red blood on the toilet paper after bowel movements. At first, he assumed it was haemorrhoids and delayed seeking advice.
When the bleeding persisted, further investigation revealed a condition that required prompt treatment. Early assessment made a crucial difference.
What Is Rectal Bleeding?
Rectal bleeding refers to blood passing from the anus, often seen in the stool, on toilet paper, or in the toilet bowl. The colour and amount of blood can vary and may offer important clues about the cause.
While rectal bleeding is often caused by benign conditions, it should never be ignored, especially if it is persistent or unexplained.
Common Causes of Rectal Bleeding
Less serious causes include:
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Haemorrhoids
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Anal fissures
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Constipation with straining
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Minor rectal irritation
Medical conditions that may cause bleeding include:
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Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
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Colonic polyps
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Diverticular disease
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Infections of the bowel
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Colorectal cancer
What Does the Colour of Blood Mean?
The colour of blood seen with rectal bleeding often gives important clues about where the bleeding is coming from.
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Bright red blood
Usually suggests bleeding from the anus or rectum. Common causes include haemorrhoids, anal fissures, or inflammation of the lower bowel. -
Dark red or maroon blood
May indicate bleeding from the colon. This can be associated with diverticular disease, polyps, inflammatory bowel disease, or colorectal cancer. -
Black, tar-like stools (melaena)
Often point to bleeding higher up in the upper digestive tract, such as the stomach or duodenum. Causes can include ulcers, gastritis, or use of certain medications. -
Blood mixed within the stool
Can suggest bleeding from inside the bowel, rather than from the anus, and should always be investigated.
Important: Colour alone cannot confirm a diagnosis. Any ongoing or unexplained bleeding requires proper medical assessment.
When Should You Worry?
You should seek medical advice urgently if rectal bleeding is:
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Recurrent or persistent
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Associated with abdominal pain
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Accompanied by weight loss or fatigue
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Linked to a change in bowel habit
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Present alongside iron deficiency anaemia
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Occurring after the age of 50
Even a single episode may warrant assessment, depending on your risk factors.
How Is Rectal Bleeding Investigated?
Assessment may include:
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A detailed medical history
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Blood tests
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Stool testing
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Flexible sigmoidoscopy or colonoscopy
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Imaging where appropriate
Identifying the cause early allows for timely treatment and reassurance.
Treatment Options
Treatment depends entirely on the cause and may include:
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Dietary and lifestyle changes
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Medications for inflammation or infection
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Treatment of haemorrhoids or fissures
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Endoscopic removal of polyps
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Specialist care for more serious conditions
Take the Next Step
Seeing blood in your stool is not something to ignore.
Early assessment can provide reassurance or allow prompt treatment where needed.