Rectal Bleeding: Should I Be Worried?

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When you notice blood in your stool, it can understandably raise your alarm bells. You can suspect the blood is coming from your rectum when you notice bright red or maroon blood in your stool, on a piece of toilet paper after you wipe, or a trickle in the toilet bowl after a bowel movement.

However, if you see black coloration in your stool, it’s also a possible sign of bleeding. In this case it’s not coming from your rectum but from farther up in the digestive tract — and you need to consult us at Triborough GI right away.

You may experience rectal bleeding due to relatively mild issues, like hemorrhoids, but also because of serious issues, like cancer. If you have bleeding that persists for more than a day or two, get checked out by a medical professional.

What causes bright red rectal bleeding?

Most commonly, rectal bleeding is caused by anal pathology such as fissures and piles. Other causes that need to be ruled out include inflammation of the lining of the bowel, benign or malignant tumors, diverticular disease and infections, which can often be sexually transmitted.

Can stress cause rectal bleeding?

While stress can contribute to a variety of stomach symptoms e.g. indigestion, a variable bowel habit and abdominal bloating and cramping, it does not typically cause rectal bleeding.

Even in patients known to have IBS, an alternative cause needs to be ruled out before rectal bleeding can be attributed to stress.

Is rectal bleeding a sign of cancer?

A tumor of the colon is a significant cause of rectal bleeding. However, even in the higher risk age group of 50 years old and above, the likelihood of rectal bleeding being caused by cancer is just under 10%. Therefore, while it’s important to rule out cancer in patients with rectal bleeding, other causes mentioned above are more commonly responsible for this symptom.

Most common causes

The most common causes of rectal bleeding include the following.

  • Anal fissures: Fissures are tearing and bleeding of the rectal or anal tissue.
  • Hemorrhoids: These are swollen veins either inside the rectum or beneath the outer skin of the anus. These enlarged veins can bleed easily under additional pressure, such as when you are having a bowel movement.

Less common causes

The following are less likely to cause rectal bleeding.

  • Bowel diseases: Many cause irritation and inflammation of the lining of the intestines.
  • Polyps: These are benign growths in the wall of the intestine and can become malignant if not removed.
  • Sexual activity of any kind that causes trauma to the anus and/or rectum: This includes infection with sexually transmitted diseases that damage these tissues.

Rare and unusual causes

The following are more rare, although possible, causes of rectal bleeding.

  • Rectal ulcers: These are sores within the lining of the rectum. These are most often due to chronic, ongoing constipation and the subsequent straining.
  • Proctitis: This is inflammation of the lining of the rectum.
  • Colon, rectal, or anal tumors: As well as the radiation therapy that may be used to treat them.

Rectal bleeding treatments and relief

When rectal bleeding is an emergency

Seek immediate treatment in the emergency room or call 911 if:

  • A significant amount of blood suddenly appears from the rectum: Whether this happens during a bowel movement or not
  • You also have severe abdominal pain or cramping
  • You feel cold, nauseated, dizzy, lightheaded, or actually faint while symptoms of rectal bleeding are occurring: This may indicate that a large amount of blood is being lost internally.

When to see a doctor for rectal bleeding

You should schedule an appointment for:

  • Rectal bleeding that happens on a regular basis: Even if there seems to be only a small amount of blood.
  • Stools that appear tarry, black, or maroon: These colors indicate larger amounts of blood.
  • Bleeding that occurs on its own and not while you are having a bowel movement
  • Ongoing pain in the anus and rectum: Often with mucus discharge

At-home treatments for rectal bleeding

For mild or occasional cases of rectal bleeding, you can try the following at home:

  • Easing constipation and promoting regularity: This can be achieved through improved diet and exercise, drinking more water, and taking an over-the-counter fiber supplement.
  • Trying warm baths and over-the-counter hydrocortisone cream for hemorrhoids

Emergency care required

If you have significant rectal bleeding accompanied by fainting, confusion, nausea, shallow breathing, dizziness, or blurred vision, call 911 right away. These are signs of shock, and you require immediate medical care.

At Triborough GI, we care about your digestive health. A one-off spot of blood isn’t a major cause for alarm, but if you notice it’s prolific or persistent, it’s best to contact Triborough GI. If you’re in New York and want to have your gastrointestinal symptoms assessed, call to set up your appointment or book it online, we have 3 convenient locations.


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