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Seeing blood in stools can be alarming for anybody. However, most of the times, the reason behind it is very innocuous. This is especially true when you notice small amounts of bright red blood on the toilet paper. Bright red blood means that the source of bleeding is somewhere near the anus and could be an anal fissure or a hemorrhoid.

Let us see some of the common causes of blood in stools.

  • Hemorrhoids: Hemorrhoids, also called as piles in common parlance, is a term used to refer to swollen veins in the anus. They are caused because of engorgement of the vessels, often as a result of straining due to constipation. Hemorrhoids are also common in the last trimester of pregnancy and in people who are obese. Piles tend to bleed during bowel movement and the bleeding is usually seen as bright red streaks in the stool or on the toilet paper. Small hemorrhoids heal on their own, but large ones have to be removed surgically.
  • Anal fissure: This is a cut in the skin of the anus resulting from the passage of very hard stools. The condition can be very painful and result in fresh bleeding every time the person strains or passes stools. The condition is usually self-healing.
  • Anal fistula: It is a small channel formed between the anal canal and the anal opening. This is again a very painful condition which leads to fresh bleeding every time the person strains.
  • Diverticula: The term refers to a small bulge in the lining of the bowel. Not much is known about the reason behind its formation. Diverticula may contain a mass of weakened blood vessels which may burst suddenly. This can lead to a bout of bleeding along with the stools. The condition is painless.
  • Angiodysplasia: This is a condition commonly encountered in the elderly people. Blood vessels present in the colon become enlarged and weakened. They may cause painless bleeding.
  • Gastroenteritis: Severe cases of bacterial or viral gastroenteritis may lead to heavy bleeding per rectum due to sloughing off of the mucosal lining of the intestines. The patient often feels the urge to relieve himself and the stools are a mixture of fresh blood and mucus.
  • Cancer and polyps of the colon: Cancer of the colon is acommon entity and rectal bleeding is usually the first sign of the underlying pathology. A patient having bleeding per rectum should get himself checked by a GP to rule out the condition, especially when:
  1. The patient is more than 40 years of age.
  2. History of passing loose stools at an increased frequency for the past six weeks.
  3. Patient is more than 60 years of age and has been noticing blood in stools for more than six weeks.
  4. Patient is suffering from ulcerative colitis.
  5. Patient is suffering from anemia
  6. The GP founds a lump during the per-rectal examination.
  7. There is a family history of colon cancer.
  • Cancer of the rectum: This condition is usually seen in the elderly people above the age of sixty.
  • Rarely, people on blood thinning agents like warfarin and aspirin may notice blood in stools.
  • Sometimes, patients suffering from inflammatory bowel disease may also complain of blood in stools.

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