Table of ContentsView AllTable of ContentsCommon CausesLess Common CausesHarmless Color ChangesWhen to Call 911DiagnosisFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Common Causes
Less Common Causes
Harmless Color Changes
When to Call 911
Diagnosis
Frequently Asked Questions
No matter the cause, it’s important to see a healthcare provider if you find evidence of blood in your stools.
This article looks at some of the common and uncommon causes of blood in stool and conditions that are sometimes mistaken for a bleed in the digestive tract. It also describes the various signs and symptoms that warrant an immediate medical investigation or emergency care.
Common Causes of Blood in Stool
The two things healthcare providers typically consider when there is blood in stool are hemorrhoids andanal fissures. This is especially true if you are passingbright red blood, a condition calledhematochezia. This often means there is a bleed in the lowerdigestive tract.
Dark red or brownish-red blood generally suggests that the bleeding is higher up in the gastrointestinal (GI) tract.Black or tarry stoolcould also indicate an upper GI bleed.
Hemorrhoids and anal fissures involve bleeding in or near the anus that can collect on stools during a bowel movement.
Verywell / JR Bee
Hemorrhoids
Hemorrhoids occur when blood vessels in the rectum or anus become swollen and inflamed. They are common, especially during pregnancy. Bleeding from hemorrhoids can develop if you are constipated, and hardened stools scrape vulnerable tissues. It can also be the result ofstraining, which increases pressure within the swollen blood vessel.
In addition to bright red blood in stools, symptoms of hemorrhoids include:
You should schedule an appointment with your healthcare provider if hemorrhoid symptoms don’t improve within a week despite conservative treatment. Severe pain or bleeding should be looked at immediately.
How Hemorrhoids Are Treated
Anal Fissures
An anal fissure is a tear in the lining of your anus. Common causes include passing large stools, chronic diarrhea, straining, pregnancy, childbirth, and anal sex.
In addition to bright red blood in stools, symptoms of anal fissure may include:
If home treatments don’t improve a mild anal fissure within five to six weeks, contact your healthcare provider. Do not wait if the pain or bleeding is severe.
How to Treat Anal Fissures
Less Common Causes of Blood in Stool
The color change results from the rapid oxidation of an iron-rich substance in the blood (calledhemoglobin) as stools pass through the digestive tract. The higher the bleeding, the more extensive the oxidation and the darker the color. Some stools can even end up lookingblack and tarry, a condition known asmelena.
There are five conditions for which this type of GI bleed might occur.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD)comes in two forms:ulcerative colitisandCrohn’s disease. Both cause persistent inflammation in the large and small intestines.
Blood in the stool is a characteristicsymptom of ulcerative colitis, though it is less common in Crohn’s disease. That said, the color of blood can vary based on where in the digestive tract the bleeding is occurring.
In addition to blood in stool, other symptoms may include:
Ulcerative colitis and Crohn’s disease are typically treated with diet and medications called aminosalicylates,corticosteroids,immunosuppressants, andbiologicsthat temper the underlyinginflammationin different ways. In severe cases, surgery is needed.
How Crohn’s Disease Is Treated
Diverticular Bleeding
In addition to blood in stools, symptoms of diverticulitis may include:
Treatment depends on the complications of diverticular disease. In general, a high-fiber diet and increased water intake are recommended. Antibiotics are used to treat diverticulitis. Severe cases of diverticulitis or recurrent diverticular bleeding may require surgery (colectomy) to remove part of the colon.
When to Call 911Diverticular bleedingwill usually stop suddenly. However, in a small number of cases, the bleeding can become life-threatening and require emergency care. If ever you have profuse rectal bleeding and large amounts of blood on your stool, call 911 or go to your nearest emergency room.
Diverticular bleedingwill usually stop suddenly. However, in a small number of cases, the bleeding can become life-threatening and require emergency care. If ever you have profuse rectal bleeding and large amounts of blood on your stool, call 911 or go to your nearest emergency room.
Upper Digestive Tract Bleeding
Digestive disease occurring higher up in the digestive tract (including theesophagus, stomach, andsmall intestine) can also cause blood in stools. Examples includepeptic ulcers,esophagitis, esophageal tears, and tumors.
If you have upper digestive tract bleeding, you will typically experience black, tarry stools (referred to asmelena).
Other symptoms of upper digestive tract bleeding include:
The treatment of severe upper digestive tract bleeding varies depending on the cause, but it can includeepinephrine (adrenaline)injections to rapidly shrink bleeding blood vessels and cauterization (burning) of blood vessels with electricity or heat to stop the bleeding. Clips or bands may also be placed around vessels to cut off the blood flow.
Colon Cancer
Blood in the stool may be the first noticeable sign ofcolon cancer.This is why it is essential that any signs of blood in your stool be brought to the attention of your healthcare provider.
With colon cancer, the color of the bloody stool can range from black and tarry to bright red, depending on the location of the tumor. With that said, tumors located in thesigmoid colon(adjacent to the rectum) may cause dark red or maroon-colored stools, while those in the rectum may result in bright red stools.
Other symptoms of colon cancer include:
The treatment depends on the stage of the cancer. It may involve surgery,radiation,chemotherapy, orimmunotherapy.
Colon Polyps
Colon polypsare growths in thelarge intestine. Most arebenign(non-cancerous) and some can turnmalignant(cancerous) over time.
Colon polyps don’t typically cause any symptoms, unless they are very large or have already turned to cancer. If symptoms do develop, they may include:
Because colon polyps tend to cause few symptoms, they are often only found during a routinecolonoscopy. To help prevent colon cancer, polyps may be removed during the colonoscopy with a procedure known aspolypectomy.
Other Causes of Stool Color Changes
Sometimesstool colorcan change when eating certain foods or taking certain supplements. You might confuse this with blood in the stools.
Harmless causes of stool color changes include:
What Should I Do If There’s Blood in My Stool?
Symptoms of hypovolemic shock include:
You should also seek emergency care if rectal bleeding is profuse and continuous or if you experience bloody or coffee-ground vomit.
If you have blood in your stools, your healthcare provider will evaluate your symptoms and decide whether or not further investigation is needed.
Based on your symptoms, a review of your medical history, and a physical exam, your healthcare provider will choose which tests are most appropriate. Blood work may or may not be taken.
Direct or indirect imaging tests are commonly ordered to check for diverticular disease, colon polyps, tumors, and other causes of GI bleeding. These include:
What’s the Difference Between Hematochezia and Melena?
Summary
A Word From Verywell
There is no such thing as a “safe” amount of blood in stools, particularly if the symptom is ongoing. You may assume that hemorrhoids are the cause, especially if you have a history of them, but persistent bleeding should be a red flag that something else may be going on.
Although colon cancer is a less likely cause of blood in stools, it is a symptom that commonly occurs when the disease is progressing. By ignoring this early symptom, you may rob yourself of the opportunity for an early diagnosis and treatment. And, in the end, the early diagnosis of cancer almost invariably affords better outcomes.
Treatment for rectal bleeding depends on the cause. For less serious issues like hemorrhoids, your healthcare provider may recommend a high-fiber diet and an over-the-counter hemorrhoid cream. More serious causes, such as colon cancer, may require surgery, chemotherapy, and radiation.
Risk factors that may cause a GI bleed include:Nonsteroidal anti-inflammatory drugs (NSAIDs)Lack of timely screening for colon cancer and polypsAlcohol use and smokingChronic vomitingGI surgery
Risk factors that may cause a GI bleed include:
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Rectal bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.National Institute of Diabetes and Digestive and Kidney Disorders.Treatment of hemorrhoids.Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: Hemorrhoids, fissures, and fistulas.Ann Gastroenterol.2020;33(1):9-18. doi:10.20524/aog.2019.0438.National Health Service (UK).Anal fissure.Centers for Disease Control and Prevention.Inflammatory bowel disease (IBD) basics.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.HealthLinkBC.Diverticular bleeding.National Library of Medicine: MedlinePlus.Diverticulitis.National Institute of Diabetes and Digestive and Kidney Diseases.Diverticular disease.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of GI bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GI bleeding.American Cancer Society.Colorectal cancer signs and symptoms.Centers for Disease Control and Prevention.Colorectal cancer basics.American College of Gastroenterology.Colon polyps.National Library of Medicine: MedlinePlus.Colonic polyps.Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther. 2018;50(2):141-149. doi:10.5603/AIT.a2017.0077MedlinePlus.Hypovolemic shock.Carney BW, Khatri G, Shenoy-Bhangle AS.The role of imaging in gastrointestinal bleed.Cardiovasc Diagn Ther.2019;9(Suppl 1):S88–96. doi:10.21037/cdt.2018.12.07Kumar AS, Ayscue J.Hematochezia and melena. In: Steele SR, Maykel JA, Wexner SD, eds.Clinical Decision Making in Colorectal Surgery. Springer International Publishing; 2020:55-63. doi:10.1007/978-3-319-65942-8_7UCLA Health.Gastrointestinal bleeding.American College of Gastroenterology.Lower gastrointestinal bleeding.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Rectal bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.National Institute of Diabetes and Digestive and Kidney Disorders.Treatment of hemorrhoids.Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: Hemorrhoids, fissures, and fistulas.Ann Gastroenterol.2020;33(1):9-18. doi:10.20524/aog.2019.0438.National Health Service (UK).Anal fissure.Centers for Disease Control and Prevention.Inflammatory bowel disease (IBD) basics.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.HealthLinkBC.Diverticular bleeding.National Library of Medicine: MedlinePlus.Diverticulitis.National Institute of Diabetes and Digestive and Kidney Diseases.Diverticular disease.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of GI bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GI bleeding.American Cancer Society.Colorectal cancer signs and symptoms.Centers for Disease Control and Prevention.Colorectal cancer basics.American College of Gastroenterology.Colon polyps.National Library of Medicine: MedlinePlus.Colonic polyps.Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther. 2018;50(2):141-149. doi:10.5603/AIT.a2017.0077MedlinePlus.Hypovolemic shock.Carney BW, Khatri G, Shenoy-Bhangle AS.The role of imaging in gastrointestinal bleed.Cardiovasc Diagn Ther.2019;9(Suppl 1):S88–96. doi:10.21037/cdt.2018.12.07Kumar AS, Ayscue J.Hematochezia and melena. In: Steele SR, Maykel JA, Wexner SD, eds.Clinical Decision Making in Colorectal Surgery. Springer International Publishing; 2020:55-63. doi:10.1007/978-3-319-65942-8_7UCLA Health.Gastrointestinal bleeding.American College of Gastroenterology.Lower gastrointestinal bleeding.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Rectal bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.National Institute of Diabetes and Digestive and Kidney Disorders.Treatment of hemorrhoids.Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: Hemorrhoids, fissures, and fistulas.Ann Gastroenterol.2020;33(1):9-18. doi:10.20524/aog.2019.0438.National Health Service (UK).Anal fissure.Centers for Disease Control and Prevention.Inflammatory bowel disease (IBD) basics.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.HealthLinkBC.Diverticular bleeding.National Library of Medicine: MedlinePlus.Diverticulitis.National Institute of Diabetes and Digestive and Kidney Diseases.Diverticular disease.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of GI bleeding.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GI bleeding.American Cancer Society.Colorectal cancer signs and symptoms.Centers for Disease Control and Prevention.Colorectal cancer basics.American College of Gastroenterology.Colon polyps.National Library of Medicine: MedlinePlus.Colonic polyps.Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther. 2018;50(2):141-149. doi:10.5603/AIT.a2017.0077MedlinePlus.Hypovolemic shock.Carney BW, Khatri G, Shenoy-Bhangle AS.The role of imaging in gastrointestinal bleed.Cardiovasc Diagn Ther.2019;9(Suppl 1):S88–96. doi:10.21037/cdt.2018.12.07Kumar AS, Ayscue J.Hematochezia and melena. In: Steele SR, Maykel JA, Wexner SD, eds.Clinical Decision Making in Colorectal Surgery. Springer International Publishing; 2020:55-63. doi:10.1007/978-3-319-65942-8_7UCLA Health.Gastrointestinal bleeding.American College of Gastroenterology.Lower gastrointestinal bleeding.
MedlinePlus.Rectal bleeding.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.
National Institute of Diabetes and Digestive and Kidney Disorders.Treatment of hemorrhoids.
Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: Hemorrhoids, fissures, and fistulas.Ann Gastroenterol.2020;33(1):9-18. doi:10.20524/aog.2019.0438.
National Health Service (UK).Anal fissure.
Centers for Disease Control and Prevention.Inflammatory bowel disease (IBD) basics.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.
HealthLinkBC.Diverticular bleeding.
National Library of Medicine: MedlinePlus.Diverticulitis.
National Institute of Diabetes and Digestive and Kidney Diseases.Diverticular disease.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of GI bleeding.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GI bleeding.
American Cancer Society.Colorectal cancer signs and symptoms.
Centers for Disease Control and Prevention.Colorectal cancer basics.
American College of Gastroenterology.Colon polyps.
National Library of Medicine: MedlinePlus.Colonic polyps.
Van der Mullen J, Wise R, Vermeulen G, Moonen PJ, Malbrain MLNG.Assessment of hypovolaemia in the critically ill.Anaesthesiol Intensive Ther. 2018;50(2):141-149. doi:10.5603/AIT.a2017.0077
MedlinePlus.Hypovolemic shock.
Carney BW, Khatri G, Shenoy-Bhangle AS.The role of imaging in gastrointestinal bleed.Cardiovasc Diagn Ther.2019;9(Suppl 1):S88–96. doi:10.21037/cdt.2018.12.07
Kumar AS, Ayscue J.Hematochezia and melena. In: Steele SR, Maykel JA, Wexner SD, eds.Clinical Decision Making in Colorectal Surgery. Springer International Publishing; 2020:55-63. doi:10.1007/978-3-319-65942-8_7
UCLA Health.Gastrointestinal bleeding.
American College of Gastroenterology.Lower gastrointestinal bleeding.
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