Why do I wipe blood after I poop?

Blood when I wipe: 11 causes of rectal bleeding

By Jennifer Huizen 

Reviewed by Alana Biggers, MD, MPH
Rectal bleeding usually refers to bleeding from the anus,
rectum, or colon, all of which are the final portions of the digestive tract.
In most cases, bright red blood indicates bleeding in the
lower colon or rectum, while darker red blood is a sign of bleeding in the
small bowel or upper colon.
Very dark or black-red blood is often associated with bleeding
in the stomach or other organs in the digestive system.
In this article, we examine 11 causes of rectal bleeding,
along with other symptoms that each one can prompt. We also look at when rectal
bleeding should be referred to a doctor.

A wide range of health conditions and factors can cause or
add to rectal bleeding.
Some of the most common causes include:
1. Hemorrhoids

Hemorrhoids are inflamed anal blood vessels, and they are
extremely common. They can develop on the outside or inside of the anus,
appearing as small bumps that occasionally bleed during bowel movements or when
Hemorrhoids, which are also referred to as piles, can impact
anyone of any age but are associated with a few risk factors, including:
  • pregnancy
  • chronic constipation and straining
  • chronic diarrhea
  • straining during bowel movements or sitting on the toilet
    for too long
  • obesity
  • low fiber or unbalanced diet
  • aging

Hemorrhoids usually respond well to over-the-counter creams
and suppositories that contain hydrocortisone. Taking warm baths frequently,
eating a high-fiber diet, and using stool softeners can also help reduce the
discomfort of hemorrhoids.
If initial treatments fail, a doctor may perform minor
surgery to remove the hemorrhoids.
2. Fistulas

A fistula occurs when an abnormal opening or pocket develops
between two neighboring organs. Fistulas that appear between the anus and
rectum, or anus and skin, can cause a discharge of white fluid and blood.
Fistulas are sometimes treated with antibiotics, but they
may require surgery if they progress.
3. Fissures

Fissures occur when tissues lining the anus, colon, or
rectum are torn, resulting in pain and rectal bleeding.
Warm baths, a high-fiber diet, and stool softeners can all
help reduce symptoms of fistula. In severe cases, fissures may require
prescription creams or surgery.
4. Diverticulitis

Diverticulosis is when small pockets called diverticula
develop on the walls of the colon around a weakness in the organ’s muscular
These pockets or diverticula are extremely common. Sometimes
diverticula can start bleeding, but this bleeding usually stops on its own.
Usually, these pockets do not cause symptoms or require
treatment unless they become infected, which is when a condition called
diverticulitis occurs.
Infected and inflamed diverticula are often painful and can
cause rectal bleeding, usually a moderate rush of blood that flows for a few
Diverticulitis is treated with antibiotics and, if severe,
5. Proctitis or colitis

Proctitis occurs when the tissues that make up the rectum
become inflamed, often resulting in pain and bleeding.
Colitis occurs when the tissues lining the colon become
inflamed. A type of colitis called ulcerative colitis can also cause ulcers, or
open, progressive sores, that are prone to bleeding.
Treatments for proctitis and colitis vary, depending on the
causes and range from antibiotics to surgery.
Common causes of proctitis and colitis include:
  • infection
  • some conditions that cause digestive problems, such as
    irritable bowel syndrome (IBS) and Crohn’s disease
  • some medications, such as blood thinners
  • radiation or chemotherapy
  • anal intercourse
  • reduced blood flow to the colon or rectum
  • a blockage in the colon or rectum

6. Gastroenteritis

Bacterial infections can cause inflammation of the colon and
stomach, causing diarrhea that may contain mucus and spots of blood. Viral
gastroenteritis does not typically cause bloody diarrhea.
Treatment for gastroenteritis usually involves fluids, rest,
and antibiotics or antivirals, depending on the cause.
7. Sexually transmitted infections (STIs)

Unprotected sexual intercourse that involves the anal area
can spread a wide range of viral and bacterial diseases. These can cause
inflammation of the anus and rectum. Inflammation, if it occurs, increases the
likelihood of bleeding.
Treatment for STIs usually involves either an antibiotic,
antiviral, or antifungal medication, depending if the cause is bacterial,
viral, or fungal.
8. Prolapse

Weakened rectal tissues can allow a portion of the rectum to
push forward or bulge outside of the anus, usually resulting in pain and,
almost always, bleeding.
Prolapse is more common in older adults than in younger
people. Some people with this condition may require surgery to correct it.
9. Polyps

Polyps are noncancerous, abnormal growths. When polyps grow
on the lining of the rectum or colon they can cause irritation, inflammation,
and minor bleeding.
In many cases, a doctor will remove polyps so they can be
tested for signs of cancer and to avoid the risk of them becoming cancerous.
10. Colon or rectal cancer

Cancer that impacts the colon or rectum can cause
irritation, inflammation, and bleeding. As many as 48 percent of people with
colorectal cancer have experienced rectal bleeding.
Colon cancer is a very common form of cancer and tends to
progress slowly, so it is often treatable if caught early.
Rectal cancer, while far rarer than colon cancer, is also
usually curable if detected and treated in time.
Some cases of colon and rectal cancer develop from initially
benign polyps. All cases of gastrointestinal cancer require treatment, which
usually involves a combination of chemotherapy, radiation therapy, and surgery.
11. Internal bleeding

Major injury to any of the gastrointestinal organs can
result in internal bleeding that passes through the rectum. Severe
gastrointestinal disease can also lead to internal bleeding.
Internal bleeding almost always requires hospitalization and
When to see a doctor
Occasional minor to mild rectal bleeding is extremely common
and will often not need medical attention or treatment.
Severe, chronic, or painful rectal bleeding may be a sign of
a more serious underlying condition and should be assessed by a doctor.
People normally notice rectal bleeding when they see streaks
or drips of blood in their stool, the toilet bowl, or when wiping. Some people
might also find blood in their underwear, or the toilet water may appear
reddish-pink after they go to the bathroom.
Some cases of rectal bleeding also cause very bad smelling,
dark, tarry stool mixed with very dark red to black blood.
Reasons to see a doctor for rectal bleeding include:
  • bleeding that lasts longer than 2 or 3 weeks
  • children with bloody stool or rectal bleeding
  • unexplained weight loss, fatigue, or weakness as well
  • painful, swollen, or tender abdomen
  • accompanying fever
  • simultaneous lumps in the abdomen
  • stool that is thinner, longer, or softer than normal for 3
    weeks or more
  • accompanying nausea or vomiting
  • accompanying long-term constipation or changes in bowel
  • associated uncontrolled leakage from the anus

Reasons to seek emergency care for rectal bleeding include:
  • vomiting or coughing up blood
  • blood running from the nose, eyes, or ears
  • bleeding that is very dark red or black
  • the reason of bloody diarrhea is unclear, such as unrelated
    to an abdominal condition or medical treatment
  • loss of consciousness or confusion
  • extreme abdominal or lower back pain

Tests and diagnosis

If bleeding is associated with an already diagnosed medical
condition, a doctor will discuss ways to manage, reduce, and track symptoms.
If the cause of rectal bleeding is unknown, a doctor will
normally ask questions about symptoms and the person’s medical history.
Depending on the severity, frequency, and accompanying
symptoms, the doctor will work out if further testing is required. A doctor may
also make a referral to a gastrointestinal or colorectal specialist.
Common tests associated with rectal bleeding include:
  • a physical examination of the anus and rectum
  • analysis of a stool sample

Specialists may perform additional tests that might include:
  • colonoscopy or flexible sigmoidoscopy where the colon is
    examined by the insertion of a tube with a camera
  • anoscopy where a device is inserted into the anus to examine
    the tissue
  • biopsy or removal of a small tissue sample for examination
  • computed tomography or CT scan that provides a 3-D image

Prevention tips
In some cases, there is no real way to prevent minor cases
of rectal bleeding. However, some factors are known to cause, contribute to, or
worsen rectal bleeding.
Common prevention tips for rectal, colon, and anal bleeding
  • eating a balanced diet that is high in fiber
  • always staying hydrated
  • not straining when going to the washroom
  • wiping the anus gently
  • treating chronic or prolonged constipation with
    over-the-counter remedies, such as stool softeners, which are available online
  • treating chronic or prolonged diarrhea with over-the-counter
    remedies, such as bismuth subsalicylate, which is available online
  • trying not to lift heavy objects unless required
  • maintaining a healthy body weight
  • taking long, warm baths frequently if experiencing symptoms
    following treatment plans set out by a doctor for related medical conditions
  • trying to avoid spicy, rich, fatty, heavily processed, and
    refined foods
  • seeing a doctor about abnormal growths in the area
  • avoiding overuse of non-steroidal anti-inflammatory (NSAID)
  • wearing a condom during sex. Condoms are available for
    purchase online.

People may wish to talk to a doctor about gastrointestinal
symptoms that may be a sign of underlying conditions, including infections,
digestive conditions, or abnormal growths.
Should you worry?

A few occasional drops or streaks of blood in the toilet,
when wiping, or in the stool, is usually not a worry.
Some people may avoid talking with their doctor about rectal
bleeding out of embarrassment and anxiety, even in moderate or severe cases.
While rare, heavy or chronic rectal bleeding can cause serious blood loss or be
a sign of an underlying condition that requires treatment.
People should see a doctor about rectal bleeding that is
chronic or noticeable, abnormal growths around the anus. It is also a good idea
to talk with a doctor about rectal bleeding that does not respond to home
People should seek emergency medical attention for rectal
bleeding or stool that is very dark, especially if they are also vomiting or
coughing up blood. It is also vital to seek immediate help for bleeding that
lasts for more than a few minutes or is accompanied by other symptoms, such as
severe pain, fever, or weakness.

Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.