Seeing blood after a bowel movement can be scary. The good news is that most rectal bleeding comes from common, treatable issues, often things like hemorrhoids or a small tear (fissure). Still, it’s worth paying attention, because the right exam can quickly tell you what’s going on and what to do next.
This guide walks you through what rectal bleeding can look like, common causes, what you can try at home, and when it’s time to seek medical attention.
What Is Rectal Bleeding? Common Signs and Symptoms
- Red blood appearing on your toilet paper
- Streaks of Red on the Stool or in the Bowl
- Blood droplets found in water from a bowel movement
- Dark, tar-like stool (less common and more concerning)
Other symptoms you may experience (or not)
- No pain at all (very common with internal hemorrhoids)
- Itching, irritation, or burning around the anus
- Feeling of pressure or fullness in the rectal area
- Small lump or swelling around the anus (which may be tender if it’s an external hemorrhoid)
- Sharp, “cutting” pain during a bowel movement (more common with a fissure)
- Constipation, straining, or hard stools that seem to be related to the bleeding
Even the smallest of streaks of blood are worth noting, as the “bigger spot” can come from something like an internal hemorrhoid. If you’re not sure what the issue is, the best course of action is to check in quickly.
Common Causes of Rectal Bleeding (And What They Might Feel Like)
Hemorrhoids
Hemorrhoids are one of the most common causes of rectal bleeding and are often related to straining during bowel movements, chronic constipation or diarrhea, pregnancy, prolonged sitting, or increased pressure in the rectal area.
They are generally not dangerous, but they can be uncomfortable and concerning, especially when bleeding is involved. Hemorrhoids are typically classified into two main types based on their location: internal hemorrhoids and external hemorrhoids. Each type tends to cause different symptoms and sensations.
Internal hemorrhoids
Internal hemorrhoids are located inside the rectum. As a result, they produce a painless, bright red bleeding that is commonly seen on the toilet paper, in the toilet bowl, or covering the stool. There may also be a feeling of fullness. Sometimes, the internal hemorrhoid may also prolapse, which is a bulge of the hemorrhoid. This may cause irritation, mucus discharge, and a feeling of something being there after a bowel movement.
External hemorrhoids
External hemorrhoids occur under the skin around the anus. As a result, they produce itching, burning, irritation, and soreness. If the external hemorrhoid thromboses, the symptoms may be much worse. This occurs when a blood clot forms inside the hemorrhoid. As a result, there is a painful, tender, firm lump that may be very uncomfortable while sitting down and while bowel movements are taking place. Even though the thrombosed hemorrhoid may resolve on its own with time, a quick checkup can reveal what is going on and if a treatment option is available.
Anal fissures
A tiny tear in the tissue that lines the anus, often caused by hard stools or straining. The giveaway? A stabbing, ‘glass-like’ pain with a tiny bit of bright-red blood and a stinging sensation that can linger after a bowel movement.
Skin irritation (dermatitis)
Inflammation or infection of the rectum (proctitis), an abscess, inflammatory bowel disease, polyps, or cancer are all possible bleeding causes. Guessing at home isn’t so good for just these reasons. A simple exam helps sort out these possible causes quickly.
Colon or rectal polyps
Polyps may bleed with little or no pain, and that is why they often catch people off guard. The bleeding may be intermittent, and the blood may appear on the toilet paper or mixed with stool, which may be bright red. Some people may not even notice the bleeding. In addition, some people may experience a slight change in their bowel habits, such as new constipation or looser stools, although many people may not experience any symptoms before the polyps are detected during a screening test.
Inflammatory bowel disease
Inflammatory bowel disease may cause bleeding, along with diarrhea, sometimes with mucus, urgency, or the feeling that they must go to the bathroom right away, and cramping pains. People may also feel fatigued or run down, and the symptoms may come and go, or flare, getting worse or better over days or weeks.
Rectal ulcers
Rectal ulcers may cause bleeding, along with rectal pain, burning, or pressure, especially during or after a bowel movement. It may feel as though they still need to go to the bathroom even after they have finished going to the bathroom, or the feeling of incomplete emptying.
When to See a Doctor About Rectal Bleeding
Call soon if you notice
- Bleeding that recurs over several days
- New bleeding you can’t explain
- Bleeding associated with itching, soreness, or a new lump
- Bleeding and constipation or straining that is not getting better with home care
Be seen promptly (same day or urgent care)
- Heavy bleeding, passing clots, or feeling dizzy/light-headed
- Severe pain, fever, or a painful lump that is rapidly enlarging as a possible abscess or thrombosed external hemorrhoid
- Black, tarry, or maroon-colored stool
- Unexplained weight loss, anemia, or chronic alteration of bowel habit
- First bleeding if you’re over age 45 or have a family history of colorectal cancer or polyps
If there’s any uncertainty about your rectal bleeding, a quick call can help. We can review your concerns and advise accordingly.
Rectal Bleeding Treatment at The Hemorrhoid Institute
At The Hemorrhoid Institute, the goal is straightforward: effective non-surgical treatment that fits into your busy schedule.
One form of treatment is Infrared Coagulation (IRC), which directs short bursts of infrared light at the small blood vessels that supply the hemorrhoid, causing them to constrict and reduce the size of the hemorrhoid over time.
IRC is completely painless because we’re not making any cuts. The actual treatment takes only about 10 minutes, and most people can resume normal activities the very same day.
It takes a few days to a week or so for the results to build up, and if there are several areas to treat, we can repeat the process several times.
Home Care to Ease Rectal Bleeding (and What Can Make It Worse)
Daily Habits That Help Prevent Rectal Bleeding: Fiber, Fluids, and Bathroom Routine
- Try to get 25-35g of fiber a day, gradually adding it with fruits, veggies, whole grains, beans, or a fiber supplement.
- Drink fluids to keep your urine light yellow.
- Go when you feel the need to go, and avoid straining.
- Avoid sitting on the toilet for too long (and for goodness’ sake, stop scrolling).
Soothing Relief for Active Symptoms: Sitz Baths and Skin Care
- Take warm sitz baths for 10-15 minutes to relax and relieve the area.
- Pat dry, don’t rub. A basic barrier cream can also soothe irritated skin.
- If you’re not sure if you’re improving in a week, it’s time to see a doctor.
Watch for a Thrombosed External Hemorrhoid
If the bleeding is accompanied by irritation, swelling, or a painful lump, it’s important to begin with the basics to provide the fastest relief from symptoms. This includes making sure stools are soft, taking warm sitz baths, and taking it easy on anything that is irritating the area.
If it is a thrombosed external hemorrhoid, the pain will increase over the first 48 to 72 hours and then gradually begin to go away. The lump will also gradually go away over a few weeks as the body absorbs the blood clot. If there is a quick and easy way to ease discomfort, we will discuss it with you and determine what is best for your situation.
Finding Relief and Getting Answers for Rectal Bleeding
Rectal bleeding is a very common symptom, and in most cases, it can be treated. If you are worried about rectal bleeding or if it persists, contact us today.
At our office, we maintain confidentiality and make next steps clear and simple for you. We will explain why you are experiencing rectal bleeding and what you can do about it. Often, we can begin treatment on your first visit.
Don’t hesitate! The longer you wait to address rectal bleeding, the greater the risk that a minor, treatable issue could become something more serious.