Seeing blood when you poop is common, but it’s not “normal” in the sense that you should ignore it. About one in seven adults report rectal bleeding over any given 12-month period, making it one of the most frequent digestive complaints. Most of the time, the cause is minor and treatable. But because the same symptom can occasionally signal something serious, it’s worth understanding what different types of bleeding mean.
Why It Happens So Often
The two most common causes of blood during a bowel movement are hemorrhoids and anal fissures. Hemorrhoids are swollen blood vessels inside or around the anus. They’re extremely common, and most don’t cause pain. You’ll typically notice bright red blood on the toilet paper or dripping into the bowl. Straining during a bowel movement, sitting on the toilet too long, pregnancy, and chronic constipation all increase your risk.
Anal fissures are small tears in the skin lining the anus, usually caused by passing a hard or large stool. Unlike hemorrhoids, fissures tend to hurt, sometimes sharply, during and after a bowel movement. The blood is also bright red and usually shows up on the paper or the surface of the stool. Most fissures heal on their own within a few weeks if you soften your stools and avoid straining.
What the Color of the Blood Tells You
The color and consistency of blood in your stool is a useful clue about where the bleeding originates. Bright red blood typically comes from the lower part of the digestive tract: the rectum, anus, or the end of the colon. This is the type you’ll see with hemorrhoids, fissures, or conditions affecting the colon like diverticular disease.
Dark red or maroon blood suggests bleeding from higher up in the colon or the small intestine. Black, tarry, sticky stools point to bleeding even further upstream, often in the stomach or upper small intestine. Blood turns dark because hemoglobin, the protein that carries oxygen in red blood cells, breaks down as it passes through the digestive tract and gets exposed to digestive enzymes. If your stool looks black and tar-like, that’s a distinct signal from the bright red streak you’d see with a hemorrhoid.
Keep in mind that certain foods and supplements can change stool color. Iron supplements, bismuth (the active ingredient in some stomach remedies), beets, and dark berries can all produce stools that look alarming but aren’t actually bloody.
Less Common but Serious Causes
Several conditions beyond hemorrhoids and fissures can cause rectal bleeding, and they usually come with additional symptoms that help distinguish them.
Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis cause chronic inflammation in the digestive tract. Bleeding from these conditions is often accompanied by persistent diarrhea, abdominal cramping, weight loss, and fatigue that lasts weeks or months. Diverticular disease, where small pouches form in the colon wall, can cause sudden, painless bleeding that’s sometimes heavy. This is more common in people over 50.
Colorectal polyps and colorectal cancer can also cause blood in the stool. This is less common than hemorrhoids, especially in younger adults, but it’s the reason rectal bleeding shouldn’t be dismissed without evaluation. The CDC recommends that most people begin colorectal cancer screening soon after turning 45. You may need to start earlier if you have inflammatory bowel disease, a family history of colorectal cancer or polyps, or a genetic condition like Lynch syndrome.
Signs That Need Immediate Attention
A small amount of bright red blood on the toilet paper after straining is, statistically, likely to be a hemorrhoid. But certain patterns warrant urgent medical care. Seek emergency help if rectal bleeding comes with any of these:
- Dizziness or lightheadedness when you stand up
- Rapid, shallow breathing
- Cold, clammy, or pale skin
- Confusion or fainting
- Blurred vision
These are signs your body is losing enough blood to affect circulation. You should also get to an emergency room if the bleeding is continuous or heavy, or if it’s accompanied by severe abdominal pain or cramping. Heavy bleeding from diverticular disease, for example, can come on suddenly and require intervention.
How Doctors Find the Source
If you bring up rectal bleeding with your doctor, the evaluation usually starts simply. A physical exam, your medical history, and questions about what the blood looks like and how often it appears can narrow things down quickly. Your doctor may also order blood tests to check for anemia (a sign of ongoing blood loss) and stool tests that can detect hidden blood you can’t see with the naked eye.
If the cause isn’t obvious, a colonoscopy is the most thorough next step. A thin, flexible tube with a camera is guided through the rectum to examine the entire colon. This can identify hemorrhoids, polyps, areas of inflammation, or diverticular bleeding, and in many cases treat the problem during the same procedure. Other imaging like CT scans may be used if the bleeding source is harder to pinpoint.
Despite how common rectal bleeding is, only about 14% of people who experience it actually visit a doctor for it within the following year. Many people assume it’s hemorrhoids and move on. That’s often correct, but a one-time evaluation gives you a baseline and rules out anything that needs attention.
Reducing Bleeding at Home
Because straining and hard stools are behind most minor rectal bleeding, the single most effective change is getting more fiber. Federal dietary guidelines recommend 14 grams of fiber per 1,000 calories you eat, which works out to about 28 grams a day on a standard 2,000-calorie diet. Most people fall well short of that. Fruits, vegetables, whole grains, beans, and lentils are the best sources. If you increase fiber intake quickly, expect some bloating at first. Ramping up gradually over a week or two helps your gut adjust.
Drinking enough water matters just as much. Fiber absorbs water to soften stool, so increasing fiber without increasing fluids can actually make constipation worse. Fruit juices and clear soups count toward your fluid intake alongside plain water.
A few habits are worth cutting back on if you’re dealing with rectal bleeding. Diets heavy in processed foods, fast food, cheese, and meat tend to be low in fiber and promote harder stools. Spending long periods sitting on the toilet, often while scrolling on your phone, increases pressure on the veins around the anus and worsens hemorrhoids. Get in, do what you need to do, and get up. Warm sitz baths (sitting in a few inches of warm water for 10 to 15 minutes) can also soothe irritated tissue and help fissures heal faster.
For most people, these changes resolve minor bleeding within a couple of weeks. If bleeding persists, becomes heavier, or you notice any change in your bowel habits alongside it, that’s a clear signal to get evaluated rather than continuing to manage it on your own.