Seeing blood after a bowel movement can be concerning. While often due to benign and treatable conditions, understanding potential causes, recognizing when medical attention is necessary, and learning about steps to promote overall bowel health is important.
Common Reasons for Bleeding
Among the most frequent causes of bright red blood after a bowel movement are hemorrhoids, which are swollen veins in the rectum or anus. Internal hemorrhoids, inside the rectum, typically cause painless, bright red bleeding, often seen on toilet paper or in the toilet bowl. External hemorrhoids, located around the anus, can also bleed but are more commonly associated with discomfort, itching, or swelling.
An anal fissure, a small tear in the anal lining, is another common reason for bleeding. These tears often result from passing hard or large stools, or from straining during bowel movements. Bleeding from an anal fissure is usually bright red and accompanied by sharp, intense pain during or immediately after a bowel movement. This pain can persist for several minutes to hours, distinguishing it from the typically painless bleeding of internal hemorrhoids.
Other Possible Causes
Other conditions can also lead to rectal bleeding. Diverticula are small, bulging pouches that can form in the lining of the digestive system, most commonly in the large intestine. When these pouches bleed, it is known as diverticulosis; if inflamed or infected (diverticulitis), bleeding can also occur.
Inflammatory Bowel Disease (IBD) encompasses chronic inflammatory conditions affecting the digestive tract, primarily Crohn’s disease and ulcerative colitis. Both can cause inflammation, ulcers, and bleeding in the intestines. Polyps are growths on the colon or rectum lining; some can bleed and may become cancerous. Infections of the digestive tract can also lead to inflammation and bloody diarrhea.
When to Seek Medical Care
Seek medical attention for persistent or heavy rectal bleeding, or if accompanied by other concerning symptoms. Dark red or black, tarry stools (melena) indicate bleeding higher in the digestive tract and warrant immediate medical evaluation. Consult a doctor if bleeding is accompanied by abdominal pain, unexplained weight loss, or significant changes in bowel habits, such as new onset constipation or diarrhea.
Dizziness, lightheadedness, or fatigue can signal anemia from blood loss. Bleeding with fever or chills may suggest an infection or widespread inflammation. Any rectal bleeding in individuals over 40 to 50 should always be evaluated by a healthcare professional to rule out more serious conditions like polyps or colorectal cancer, even if the bleeding appears minor.
What to Expect at the Doctor’s Office
A doctor’s visit for rectal bleeding begins with a detailed medical history, covering bleeding characteristics, bowel habits, and associated symptoms. A physical examination follows, which may include a visual inspection of the anal area and a digital rectal exam to check for abnormalities.
To examine the lower digestive tract, the doctor might perform an anoscopy or proctoscopy, inserting a short, lighted tube into the anus. For a more comprehensive examination of the entire colon, a colonoscopy may be recommended. During a colonoscopy, a flexible tube with a camera visualizes the colon to identify potential sources of bleeding like polyps or inflammation. Blood tests may also be ordered to check for anemia, and stool tests can help detect hidden blood or infections.
Steps to Promote Bowel Health
Maintaining a healthy digestive system helps prevent common causes of rectal bleeding and promotes bowel regularity. A high-fiber diet, with plenty of fruits, vegetables, and whole grains, adds bulk to stool and helps soften it for easier passage. Adequate hydration is equally important, as drinking enough water helps keep stools soft and prevents constipation.
Establishing regular bowel habits, by responding to urges and avoiding straining, supports digestive health. Regular physical activity promotes healthy muscle contractions in the intestines. Warm sitz baths can provide soothing relief for minor anal irritation. Over-the-counter options like fiber supplements or stool softeners can aid regularity, but discuss these with a healthcare provider.