8 Possible Reasons You’re Pooping Blood—And When to See a Doctor

If you search online for “Why am I pooping blood?” you’ll find one big, recurring piece of advice: See a doctor. Which, yeah! That’s always your best bet, especially if you’re in pain or there’s a lot of blood, or you’re having this issue for longer than a day or two. But if we’re being honest here, we know that most people aren’t going to rush to see a health care provider when they first see a bit of blood in their poop, especially if it’s just a little, and it only happens once or twice and then (thankfully) disappears.

Still, as you know from a lifetime of pooping, rectal bleeding isn’t a typical thing. So how do you know if you can brush it off or if you need to seek medical care? We asked some experts about why you might be pooping blood—and when it's time to see a health care provider.

Bloody poop meaning | Bloody poop causes and home remedies | Treatment and tests for bloody poop | Bloody poop prevention | When to see a doctor for bloody poop | Black bloody poop

Blood that’s coming out of your butt might be the result of a few things. “Rectal bleeding” typically refers to bleeding coming from your lower colon or rectum. The small amount of red blood that you may notice coating your poop, blotting your toilet paper, or dripping into the toilet bowl are all most commonly coming from the rectum. But blood in your poop can also come from other areas of your digestive system. For example: A gastric ulcer, which is an open sore that develops on the inside lining of your stomach, can cause bleeding in your GI tract that leads to bloody poop.

Back to top

Unless you happen to be a gastroenterologist (in which case, very cool!), it's hard to determine on your own why you have blood in your poop. That’s why the “See your doctor” recommendation comes up so frequently—and for good reason. If you see blood in your poop and are over 45, Black, or have a family history of colorectal cancer, you should see a doctor to rule it out, since you’re at a higher risk. (We’ll talk a bit more about this type of cancer below.)

Still, sometimes you can try out a few things on your own. Of course, the advice is a little different depending on what you might be dealing with. In general, any bleeding in your gastrointestinal tract happens because blood vessels are exposed and bleeding into the GI tract. This is always unusual and worth investigating, but the actual underlying reason for this bleeding varies based on the disease process and the location.

Though it’s hard to suss out on your own why you’re finding blood in your poop, it’s still good to have some idea of what you might be dealing with. Here are the most common reasons you might be pooping blood.

If you have hemorrhoids, you’re in good (though uncomfortable) company: Around 1 in 20 people will deal with these piles of swollen anal or rectal veins at some point in their lives, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

You can get hemorrhoids when you strain too much when trying to poop, sit on the toilet for too long, or have diarrhea or constipation. Pregnancy, which often causes constipation and increases pressure on your lower body (including your anus), is another common culprit. Sometimes you won’t even realize you have hemorrhoids, but pushing in the bathroom can make a hemorrhoid bleed. 

Blood from hemorrhoids is typically bright red. Since hemorrhoids form on or close to your anus, blood doesn’t have time to clot up and darken before it exits the premises, Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California, tells SELF.

Hemorrhoids usually clear up on their own. Still, they can stick around and cause persistent bleeding, Dr. Farhadi says. If hemorrhoids are indeed your issue, Dr. Farhadi recommends eating high-fiber foods to try to soften up your waste so pooping won’t require Herculean effort. (Be sure to also drink enough water, since the fiber soaks it up to help make poop softer and easier to pass.)

Your anus is lined with thin, moist tissue called mucosa, and when you get a small tear in that mucosa, it’s known as an anal fissure. You usually get an anal fissure when you expel an extraordinarily hard or large poop. As you can imagine, that can cause pain and bleeding. The anal-fissure-induced blood you’ll see on your TP or in the toilet will likely be bright red, as it is with hemorrhoids. Other causes of anal fissures include constipation, chronic diarrhea, and giving birth.

Christine Lee, MD, a gastroenterologist at Cleveland Clinic, likens anal fissures to having a paper cut on your butt. Yowza! Luckily, they usually get better on their own, though you can ask a doctor if they can recommend an anesthetic cream to dull the pain in the meantime. It can also help to take a sitz bath and increase your fiber intake (so that your future poops are a little more manageable).

“Diverticulosis is the presence of little pouches in the colon, which can sometimes cause bleeding,” Kyle Staller, MD, a gastroenterologist at Massachusetts General Hospital, tells SELF. Complications of these common pouches include rectal bleeding.

Diverticular bleeding sometimes stops on its own. If that's not the case for you, see a doctor, who might do or refer you for a colonoscopy, which helps them figure out where the bleeding is happening so they can put an end to it.

A polyp is a small mass of cells that can form on the lining of your colon (also known as your large intestine). Though anyone can develop colon polyps, they’re more common in those who are 45 or older, smoke cigarettes, or have a personal or family history of colon polyps or colon cancer. It’s normal to have a colon polyp without symptoms, but some people with polyps experience rectal bleeding and red or black poop, according to the NIDDK. (And black poop is a big deal that you should see a doctor about—see below for more info on that front.)

Most of these polyps are harmless, but in rare cases, they can develop into colon cancer over time. Doctors treat colon polyps by removing them endoscopically (using a flexible camera with a light, also called an endoscope), then making sure they’re not cancerous.

Escherichia coli is a type of bacteria that actually already naturally lives in your gut, according to the National Institute of Allergy and Infectious Diseases (NIAID). A healthy amount of E. coli is actually key for a well-functioning GI tract, but certain strains of E. coli can cause GI issues, including bloody diarrhea.

The good news: Healthy adults usually recover from E. coli–related issues in about a week. In general, resting and drinking plenty of fluids to help prevent dehydration is the main thing to do. The bad news: E. coli that causes bloody diarrhea can sometimes make people sick enough to wind up in the hospital. At the hospital, you can receive supportive care, like IV fluids, blood transfusions, and kidney dialysis, if necessary.

Even if you have a mild case and a doctor says you can recover at home, don’t take antidiarrheal medication, which slows down your digestive system and can make it take longer to feel better.

A peptic ulcer is an open sore that develops either on the inside lining of your stomach (gastric ulcer) or the upper portion of your small intestine (duodenal ulcer). These ulcers can happen due to bacterial infections and the use of NSAID painkillers like aspirin, ibuprofen, and naproxen sodium, according to the NIDDK.

While the majority of people with peptic ulcers have no symptoms, the most common symptom you might experience is abdominal pain. However, in less common and more severe cases, you can also end up with dark blood in your poop. “It can look like driveway tar—it’s shiny and sticky and has a peculiar odor to it,” Gail Bongiovanni, MD, a gastroenterologist and adjunct professor in the division of digestive diseases at the University of Cincinnati College of Medicine, tells SELF. This dark stool is also known as melena and can have a consistency like peanut butter. If you notice it, it suggests that you need an evaluation of your upper intestinal tract to locate the source of the bleeding.

Doctors may prescribe drugs to neutralize irritating stomach acid or medications to help protect the tissues that line your stomach and small intestine. If your peptic ulcer is bleeding, you will need a procedure known as an upper endoscopy so a gastroenterologist can treat the bleed and stop it from bleeding again.

Though these are two different forms of inflammatory bowel disease (IBD), both Crohn’s and ulcerative colitis can cause chronic inflammation in your digestive tract that leads to bleeding ulcers—hence you pooping blood.

In case you’re not familiar with it, Crohn’s disease is a chronic disease that causes inflammation and irritation in your digestive tract, usually in your small intestine and the beginning of your large intestine, per the NIDDK. Ulcerative colitis is a chronic disease that causes irritation or swelling and sores called ulcers on the inner lining of your large intestine.

IBD treatment courses vary from person to person, but they can involve taking anti-inflammatory drugs like corticosteroids to tame inflammation, immunosuppressants to stop your immune system from attacking your digestive tract, and medicine to combat symptoms like diarrhea and constipation. A doctor may also recommend surgery if other treatments haven’t helped as much as they should. Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options might be best for you.

Bright red rectal bleeding can sometimes be due to colorectal cancer, according to the American Cancer Society (ACS). Colorectal cancer is tough to pin down—it may not cause symptoms right away, the American Cancer Society says, and when it does, rectal bleeding can show up alone or with other issues. You might also experience things like diarrhea, constipation, a persistent urge to poop, a change in your stool shape or size (e.g., they become pencil-thin), abdominal pain, weakness and fatigue, and unintended weight loss. 

Risk factors for colorectal cancer include a personal or family history of colorectal polyps, a personal or family history of irritable bowel disease like Crohn’s colitis or ulcerative colitis, being Black, and being above 45, per the ACS. (However, colorectal cancer rates are significantly rising in younger people too.)

Back to top

If you have blood in your poop and see a health care provider for it, the doctor is going to need to do a little investigating to help figure out what’s behind it. There are a lot of different things a doctor may do to try to give you a diagnosis, per the NIDDK:

• A physical exam. This usually includes listening to sounds in your abdomen with a stethoscope and palpating certain areas of your body.
• Lab tests. You can expect a blood test to help determine how much you’re bleeding and whether you have anemia, a condition where you don’t have enough healthy red blood cells to carry enough oxygen to your body’s tissues.
• Endoscopy. This diagnostic test involves a gastroenterologist placing an endoscope into your gastrointestinal tract. When performed through the mouth, this is known as an upper endoscopy. When performed through the anus, it’s a colonoscopy. If you're experiencing red blood in your poop, the gastroenterologist will usually start with a colonoscopy. If you’re experiencing poop with dark or black blood, your gastroenterologist will usually start with an upper endoscopy. Of course, there are exceptions to these rules.
• Imaging tests. Those can include an abdominal CT scan, and an upper or lower GI series, where you swallow a chalky liquid called barium and then undergo X-rays to help the doctor see what’s happening in your GI tract.
• Gastric lavage. This is a procedure where a doctor passes a tube through your nose or mouth into your stomach to try to find the cause of your bleeding. It’s not done often these days, but in rare cases, doctors still do it when trying to distinguish between bleeding in the upper and lower GI tract.
• Surgery. If none of the other tests help find a diagnosis, a doctor may recommend that you undergo surgery to try to figure out what’s happening. That can include a laparotomy, where a surgeon will make a cut in your abdomen and explore the area, or a laparoscopy, where a surgeon uses a laparoscope to make small cuts in your abdomen, then inserts special tools and a camera to try to find and treat the source of the bleeding.
  
  Back to top

The best way to prevent having more bloody poop in the future really depends on what’s behind this symptom for you.

If you have bloody poop due to something like an anal fissure or hemorrhoids, doing your best to eat high-fiber foods and drink plenty of water can help keep your poop small, manageable, and less likely to injure you on the way out. Being careful not to use painkillers over longer periods may help prevent peptic ulcers in the future. And being wary of unpasteurized milk and undercooked food like ground beef can lower your risk of coming down with a food-borne illness like E. coli that can lead to bloody poop.

Unfortunately, you can't prevent Crohn’s disease, ulcerative colitis, colon polyps, and diverticulosis—those conditions are largely determined by things outside of your control, like genetics or getting older. But, with all of these conditions, eating well and exercising regularly may help make symptoms easier to deal with.

Back to top

As you might have gleaned above, a little bit of bright red blood in your poop isn’t always a huge cause for concern. If you’ve been in great health, saw a small amount of bright red blood just once, and the bleeding went away on its own, you probably don’t need immediate medical attention, Dr. Lee says. That bleeding is most likely due to a hemorrhoid or anal fissure. Your butt has a hard job to do, so bleeding can just come with the territory sometimes.

But if the blood in your poop is dark, you’re seeing a lot of it, or you’re experiencing other strange symptoms, see a doctor. The same goes for if your bleeding persists for days or goes away and comes back seemingly at random. Even if it doesn’t, it’s still a good thing to mention the next time you visit your doctor. And, again, you should absolutely seek medical attention immediately if you notice blood in your stool and have any concern you may be at risk of colorectal cancer.

Your other symptoms matter too. If you have bleeding and you’re also struggling with shortness of breath, abdominal pain, chest pains, dizziness, fatigue, and a fever, it could be a sign of bleeding in your GI tract, Dr. Lee says. This is another time that anal bleeding should mean an immediate trip to the doctor’s office.

If you’ve already been diagnosed with a health condition that can cause blood in your toilet bowl, like Crohn’s disease or ulcerative colitis, and you’re managing it with the help of your doctor, you don’t necessarily need to call your doctor every time you spot a little blood, Dr. Farhadi says. However, it’s crucial to put it into context. If you used to have a flare-up every two months and suddenly you’re seeing a significant amount of blood in your poop and more often than usual, you should call your doctor, he says—it could be a sign that your condition isn’t as well-controlled as you thought.

Back to top

If your poop is black, that’s a big red flag that could signal internal bleeding, Dr. Bongiovanni says. That said, eating black licorice, blueberries, beets, or taking iron supplements or certain medicines can result in block poop, per the US National Library of Medicine. So as a rule of thumb: If your poop is black and you didn’t recently have any of these foods or drugs, get to a doctor ASAP, just in case.

Back to top

Related:

• Here’s Why Stress Messes With Your Poop
• Should You Always Close the Toilet Lid Before Flushing?
• 7 Things That Can Cause Bizarre Green Poop