Seeing blood in your stool can be alarming and unsettling. While rectal bleeding does not always point to a serious condition, it should never be ignored entirely. In many cases, the cause is mild and may resolve with simple treatment. In others, however, it can signal an underlying issue that benefits from early medical attention.
Understanding what blood in the stool may indicate and when it warrants further evaluation can help you respond appropriately without unnecessary alarm. Here, we look at what different types of rectal bleeding may mean, and when it is important to seek medical advice. Read on to learn how to recognise warning signs and take the right steps for your health.
Understanding Blood in Stools
The colour and appearance of blood in your stool can offer useful clues about where the bleeding may be coming from, often guiding doctors on whether further investigations such as a colonoscopy may be needed. These differences relate to how far the blood has travelled through the digestive tract and how long it has been exposed to digestive processes.
You may notice blood in several forms:
- Bright Red Blood: This often points to bleeding in the lower gastrointestinal (GI) tract, such as the rectum or anus. The blood appears fresh because it has not travelled far enough through the bowel to darken or mix with stool.
- Dark Red or Brown Blood: This may indicate bleeding from higher up in the colon or small intestine. As the blood moves through the digestive tract, it gradually darkens and blends with the stool.
- Black or Tarry Stools: This usually suggests bleeding from the upper GI tract, including the oesophagus, stomach or duodenum. The blood turns black and sticky because it has been chemically altered during digestion.
- No Visible Change: In some cases, bleeding is present but not noticeable to the naked eye. This type of bleeding, known as occult bleeding, can only be detected through laboratory testing.
Possible Causes of Blood in Stool
Blood in the stool can arise from a range of conditions, some of which are mild and temporary, while others require closer attention. Common causes include:
- Haemorrhoids: Swollen veins in the rectum or anus that may bleed during bowel movements, especially with straining or hard stools.
- Anal Fissures: Small tears in the anal lining, often linked to constipation, that cause pain and bright red bleeding.
- Diverticular Disease: Bleeding can occur when a blood vessel within a diverticulum ruptures, sometimes leading to sudden and noticeable bleeding.
- Colorectal Polyps or Cancer: Abnormal growths can disrupt the bowel lining and cause intermittent bleeding.
- Inflammatory Bowel Disease (IBD): Chronic inflammation from Crohn’s disease or ulcerative colitis may lead to blood or mucus in the stool.
- Gastrointestinal Infections: Certain infections can inflame or damage the intestinal lining, resulting in bloody diarrhoea.
Understanding these possible causes provides helpful context, but proper evaluation by a healthcare professional is essential for an accurate diagnosis.
When to Be Concerned
Occasional minor bleeding may have a straightforward explanation, but certain situations call for prompt medical review. Delaying assessment can affect how some conditions are managed, particularly colorectal cancer, where early detection plays a key role in outcomes.
You should seek medical advice if you notice:
- Persistent bleeding or passing a large amount of blood
- Bleeding accompanied by abdominal pain, weight loss, fatigue or changes in bowel habits
- A family history of colorectal cancer or polyps
- Any blood in the stool in individuals aged 50 and above
- A personal history of gastrointestinal conditions, bleeding disorders or liver disease
Diagnostic Procedures for Blood in Stool
If blood is detected in your stool, your doctor may recommend further investigations to identify the source and cause of the bleeding. These tests help guide appropriate treatment.
- Physical Examination: This includes an overall assessment and may involve a digital rectal examination to check for abnormalities in the rectum or anus.
- Stool Tests: Laboratory tests can detect hidden blood not visible to the eye, such as through faecal occult blood or faecal immunochemical tests.
- Endoscopic Procedures: Colonoscopy, sigmoidoscopy or upper endoscopy allow direct visualisation of the digestive tract using a flexible camera. These procedures help identify inflammation, polyps or active bleeding.
- Imaging Tests: CT scans or MRI scans may be used when the source of bleeding is unclear or located beyond the reach of endoscopy. These imaging methods provide detailed views of the digestive system and can help detect deeper or less obvious issues.
Treatment Options Based on Diagnosis
Treatment for blood in stool depends on the underlying cause. Different conditions require different approaches, ranging from simple lifestyle adjustments to more advanced medical or surgical interventions.
- Haemorrhoids: Initial management often includes dietary changes, increased fibre intake and topical treatments. Persistent cases may benefit from minimally invasive procedures such as rubber band ligation.
- Anal Fissures: Treatment focuses on promoting healing through topical medications, pain relief and stool-softening measures. In selected cases, minor surgery may be recommended.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease and ulcerative colitis are typically managed with a combination of medications and lifestyle changes to reduce inflammation and control symptoms.
- Colorectal Cancer: Management depends on the stage and extent of the disease. Treatment options may include surgery to remove the tumour, chemotherapy, radiation therapy or a combination of these approaches.
Your healthcare professional will recommend the most suitable treatment based on the diagnosis, overall health and individual needs.
Knowing When to Seek Medical Advice
Noticing blood in your stool can be unsettling, but understanding the possible causes and recognising when to act makes a meaningful difference. Paying attention to accompanying symptoms, changes in bowel habits, or persistent bleeding allows you to make informed decisions about your health rather than delaying care.
If you have noticed blood in your stool or are concerned about your symptoms, schedule a consultation with our colorectal surgeon today. A personalised assessment can help clarify the cause, explore suitable treatment options and guide you through the next steps with confidence.