Medically reviewed by the clinical team at Consultants in Gastroenterology
Noticing blood in your stool can be frightening. Your mind may race to the worst possible explanations. You can take comfort in knowing that most causes of rectal bleeding are not life-threatening, but all of them deserve attention, and none of them should be ignored. As gastroenterologists, we regularly see this concern among our patients. We help explain what is happening, identify the cause, and address it.
Here is a simple guide to help you know what to watch for, what different types of bleeding may mean, and when it is time to call our office.
What Does Blood in Stool Actually Look Like?
Blood in the digestive tract does not always look the same, and the appearance can tell us a great deal about where it is coming from.
- Bright red blood on the toilet paper, in the bowl, or coating the stool usually indicates bleeding from the lower part of the digestive tract. That includes the rectum, the sigmoid colon, or the anus itself. Hemorrhoids are a very common culprit, and so are small tears called anal fissures.
- Dark red or maroon blood mixed into the stool tends to come from higher up in the colon. This type warrants a prompt evaluation.
- Black, tarry stools with a distinct foul odor are a sign of bleeding in the upper digestive tract, such as the stomach or small intestine, called melena. It requires urgent attention.
- Occult blood is blood you cannot see at all. It is only detectable through a stool test and often found during routine colorectal cancer screening, which is one of the most important reasons to stay current with your screenings.
Common Causes of Rectal Bleeding
Most patients who come to us with blood in their stool have a benign, treatable condition. Here are the most common ones we see.
Hemorrhoids are swollen veins in the rectum or around the anus. They are extraordinarily common and are the leading cause of bright red rectal bleeding in adults. They can cause pain, itching, and bleeding, especially with straining during bowel movements. Rarely dangerous, they can be uncomfortable and may require treatment.
Anal fissures are small tears in the lining of the anus. They typically cause sharp pain during or after a bowel movement along with bright red bleeding. They are most often caused by passing hard stools.
Diverticular disease involves small pouches that form in the walls of the colon. When one of those pouches bleeds, it can produce a significant amount of bright red or dark red blood. Diverticular bleeding is one of the more common causes of heavier rectal bleeding in adults over 50.
Inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, can cause bleeding along with cramping, diarrhea, and weight loss. These are chronic conditions that require ongoing management, but they can be treated very effectively.
Colon polyps are growths on the inner lining of the colon. Most are benign, but some can bleed, and certain types can develop into colorectal cancer over time if they are not removed. Colonoscopy allows us to find and remove polyps before they become a problem.
Colorectal cancer is on this list; however, it is important to keep things in perspective. While rectal bleeding can be a symptom of colorectal cancer, it is far more often caused by something else. Early-stage colorectal cancer frequently causes no symptoms at all, which is why routine screening is so valuable.
When Should You Call Us Right Away?
Some situations require prompt evaluation. Please contact our office as soon as possible if you experience any of the following:
- Blood in the stool that is persistent or recurring
- A significant amount of blood in the toilet bowl
- Dark red or maroon-colored stools
- Black, tarry stools
- Rectal bleeding accompanied by abdominal pain or cramping
- Bleeding with unexplained weight loss
- Bleeding with a change in your normal bowel habits, such as new constipation or diarrhea that lasts more than a few weeks
- A family history of colorectal cancer, and you have not yet been screened
When Is It a Medical Emergency?
Please go to the emergency room or call 911 if you experience heavy, ongoing rectal bleeding, or if bleeding is accompanied by dizziness, lightheadedness, fainting, rapid heartbeat, or significant weakness. These signs can indicate serious blood loss that needs immediate care.
The Role of Colorectal Cancer Screening
Many patients ask whether their bleeding could be cancer. It is a fair and important question to ask.
The best protection against colorectal cancer is not waiting until you have symptoms. It is getting screened before symptoms ever appear.
Current guidelines recommend that average-risk adults begin colorectal cancer screening at age 45. If you have a family history of colorectal cancer or polyps, we may recommend starting earlier.
A colonoscopy remains the gold standard for screening. It allows us to examine the entire colon directly, remove any polyps we find, and often get you answers the same day. For many patients, it is far less intimidating than expected.
IMPORTANT: Do Not Wait to Feel “Certain” It Is Something Minor
Many patients wait weeks or months before seeking evaluation because they assume their bleeding is “just hemorrhoids.” Sometimes it is, but the only way to know for certain is to be examined by a specialist.
Early detection makes an enormous difference in outcomes for colorectal cancer and other serious conditions. A conversation with a gastroenterologist is straightforward and, in most cases, gives you peace of mind.
What to Expect at Your Appointment
When you come to see us, we will begin with a thorough conversation about your symptoms, medical history, and family history. Depending on what we find, we may recommend a physical examination, a flexible sigmoidoscopy, or a full colonoscopy.
Our goal is to give you clear answers and a clear path forward. You should leave our office with more clarity than when you arrived.
Reach Out to Consultants in Gastroenterology in Columbia, SC
If you have noticed blood in your stool, do not put off getting it evaluated. Our teams at our Columbia, SC, locations are here to listen, to examine, and to guide you toward the right answers. We see patients at every stage of concern, from routine screening to the evaluation of more complex symptoms.
Your health is worth the conversation. We are here when you are ready.
To schedule an appointment with one of our gastroenterologists, call our office or request a visit online. We look forward to taking good care of you.