Jay Yepuri, MD, MS, is board-certified in gastroenterology. He is a partner with Digestive Health Associates of Texas and a medical director at Texas Health Harris Methodist HEB Hospital .

If rectal bleeding is accompanied by severe abdominal pain, vomiting that won’t stop, or dizziness and fainting, call 911 and seek medical help immediately.

Rectal bleeding is not normal and it can be upsetting. There are common reasons for bleeding such as hemorrhoids or a tear in the anal canal. Less common reasons include colon or rectal cancer, inflammatory bowel disease (IBD), diverticulosis , or ischemic colitis .

The medical term for bright-red blood in the stool is hematochezia . Whatever the potential cause, it is never normal and should always be investigated by a healthcare provider. 

This article will address some of the reasons for rectal bleeding and how the cause might be diagnosed and treated.

Chakrapong Worathat / EyeEm / Getty Images

Rectal bleeding is when there is blood being passed out of the anus during a bowel movement on or in the stool, or by itself without stool. You might see it in the toilet bowl or on toilet paper after wiping.

The blood could be anything from bright red to black:

The amount of blood is also helpful in figuring out where it might be coming from. A little bit of blood in the toilet can look like a lot when it hits the water. It’s important to get a look at it so that you can give the healthcare provider an idea of how much blood might be involved.

There are several causes of rectal bleeding.

Some of the more common reasons include:

Some of the less common or rare reasons for rectal bleeding include:

Rectal bleeding can be caused by a tear in the anal canal that’s from straining to have a bowel movement or having hard stool (constipation). Many medications can lead to the development of constipation.

Some of them can include:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin (ibuprofen) and Aleve (naproxen) can cause intestinal ulcers that can lead to rectal bleeding.

There are other medications that can increase the risk of bleeding in the body. If there’s an ulcer or another issue going on in the digestive system, a medication that increases bleeding could cause it to bleed more than it normally would.

Some of these medications are:

The treatment for rectal bleeding will depend on the cause. These treatments may be used for the most common causes:

Treatments for less common causes include:

Rectal bleeding can lead to enough blood loss that a person develops anemia (a low number of healthy red blood cells). This can further be complicated by heavy menstrual periods or other problems in the body making enough red blood cells, such as a lack of important vitamins and minerals. 

With severe blood loss, there is a risk of serious complications, including death. For bleeding that comes on suddenly and won’t stop, seek help in the emergency department right away.

In some cases, a test that can see the inside of the body is used to understand the cause of rectal bleeding. This could be a test to directly see inside the anus, rectum, and colon, or it could be an imaging test that gives a picture of the internal organs.

One or more of these tests might be used to find the cause of rectal bleeding: 

Rectal bleeding is always a reason to have a touchpoint with a healthcare provider. For chronic conditions that cause bleeding during a flare-up, it is still important to get advice from a provider.

Bleeding from the rectum isn’t normal, and it is a sign that something is wrong. It could mean needing a diagnosis to find the cause of the bleeding or it could mean that a change is needed to better manage an already diagnosed condition.

Hemorrhoids are a common reason for bleeding. However, even hemorrhoids need to be diagnosed by looking at them. A diagnosis shouldn’t be made without a healthcare provider looking at the anus to see what the problem could be.

Seek emergency medical attention if rectal bleeding is accompanied by severe abdominal pain, vomiting, dizziness, or fainting,

Rectal bleeding is always a reason to talk to a healthcare provider. There are many possible causes of bleeding from the rectum, and because it is not ever normal, it’s a sign that there’s a problem that needs to be addressed.

Seeing blood in the toilet bowl, on toilet paper, or on or in the stool is a shock. Even if it has happened before and you already know that you have hemorrhoids, IBD, or diverticular disease, it is still unsettling.

You may choose to ignore the blood or to hope that the bleeding stops on its own. But it may not happen that way, and catching a problem earlier rather than later can get you the right diagnosis and treatment.

It may help to remember that healthcare providers assist people with rectal bleeding every day, and they will not be shocked or surprised by what you tell them.

There are many possible reasons for blood to be coming from the rectum but some of the most common conditions that cause bleeding are hemorrhoids, an anal tear or fissure, diverticular disease, or ulcers.

Bleeding from the rectum should always be discussed with a healthcare provider to determine the cause because it could result from more serious conditions. 

If the bleeding is from a condition that can improve with home remedies, such as hemorrhoids, it might get better on its own. However, even if you have had hemorrhoids or an anal fissure before and think you have one again, you should still see a healthcare provider to be sure.

This will ensure you get the right treatment and that the bleeding is not from a cause that needs to be treated in a different way.

Colon cancer starts with an abnormal growth in the colon called a polyp. Polyps start out small and grow and may eventually start to bleed. The goal of colon cancer screening is to remove the polyp before it gets larger and has the opportunity to turn cancerous.

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