Blood in Your Stool? Here's What It Could Mean
- AGG
- Jul 14
- 2 min read
Finding blood in your stool — whether it's on the toilet paper, in the toilet bowl, or mixed into the stool itself — is one of the most common reasons patients call our office. And it's the right thing to do. Blood in the stool should never be dismissed as 'probably nothing' without evaluation, regardless of your age.
Here is a straightforward guide to what rectal bleeding can mean, and why seeing a gastroenterologist is the right call.
Not All Rectal Bleeding Looks the Same
The appearance of blood in or near the stool provides important clues about its source:
Bright red blood on toilet paper or in the toilet bowl: Typically comes from the lower rectum or anus. Hemorrhoids and anal fissures are the most common causes.
Bright red blood mixed with stool: Can indicate bleeding from higher in the colon — polyps, diverticular disease, IBD, or colorectal cancer.
Dark red or maroon blood mixed with stool: Suggests bleeding from the right colon or small intestine.
Black, tarry, foul-smelling stool (melena): Indicates bleeding from the upper GI tract — the esophagus, stomach, or duodenum. Requires urgent evaluation.
Occult blood (invisible to the naked eye): Detected only on stool tests or as iron deficiency anemia. Can be an early sign of colorectal cancer.
Common Causes of Rectal Bleeding
Hemorrhoids
The most common cause. Internal hemorrhoids typically cause painless, bright red bleeding. While hemorrhoids are benign, they should be confirmed rather than assumed — especially in patients over 45 who have not had a recent colonoscopy.
Anal Fissures
Small tears in the anal lining, typically caused by straining or passing hard stool. Usually cause bright red bleeding and pain during and after bowel movements.
Diverticular Bleeding
One of the most common causes of significant lower GI bleeding in adults over 50. Usually painless and sudden. Most episodes resolve on their own, but some require colonoscopy with treatment.
Colorectal Polyps
Polyps can bleed silently or cause visible blood in the stool. Colonoscopy allows detection and removal in the same procedure.
Colorectal Cancer
Rectal bleeding — particularly blood mixed with stool, accompanied by a change in bowel habits, or occurring in a patient without another explanation — raises the possibility of colorectal cancer. Early-stage colorectal cancer is highly treatable. Late-stage is not. This is why evaluation matters.
Inflammatory Bowel Disease
Bloody diarrhea is a hallmark symptom of ulcerative colitis. Crohn's disease can also cause GI bleeding.
When to Seek Immediate Care
Go to the emergency room for: large-volume rectal bleeding, dark tarry stool, bleeding with dizziness or fainting, or bleeding with severe abdominal pain.
When to Call a Gastroenterologist
Any new or unexplained rectal bleeding deserves evaluation. This is especially true if you are over 45, have not had a recent colonoscopy, or have any associated symptoms like weight loss, fatigue, or changes in bowel habits.
📅 Don't wait on rectal bleeding. Book an evaluation at (908) 851-2770 or schedule online.
Medical Disclaimer: This blog post is intended for general informational and educational purposes only and does not constitute medical advice.
