Sometimes people see blood on the paper after wiping. Hemorrhoids are the most common reason, but rectal bleeding may also indicate a serious gastrointestinal condition that needs medical attention.
A few occasional drops or streaks of blood when wiping are not usually worrying.
That said, different shades of blood may indicate bleeding from different parts of the digestive system.
- Bright red blood in the stool may indicate bleeding in the lower colon or rectum.
- Darker red blood may be a sign of bleeding in the small bowel or upper colon.
- Very dark or black-red blood often means there is bleeding in the stomach or other organs of the digestive system.
This article reviews 11 causes of rectal bleeding, along with additional symptoms of each and when to see a doctor.
Many health conditions and factors may cause or add to rectal bleeding.
In the United States, hemorrhoids affect about 1 in 20 people and nearly
Hemorrhoids, sometimes referred to as piles, may impact anyone. But, some factors may put people at a higher risk of developing them, such as:
- chronic constipation
- chronic diarrhea
- straining during bowel movements
- lifting heavy objects
- sitting on the toilet for too long
- a low-fiber or unbalanced diet
- being over the age of 50
Treatment for hemorrhoids usually involves over-the-counter (OTC) creams and suppositories that contain hydrocortisone. Taking warm baths, eating a high-fiber diet, and using stool softeners may also help reduce the discomfort of hemorrhoids.
If initial treatments fail, a doctor may perform minor surgery to remove the hemorrhoids.
A fistula occurs when an abnormal opening or pocket develops between two neighboring organs. Fistulas that appear between the anus and rectum, or anus and skin, could cause a discharge of white fluid and blood.
Doctors sometimes treat fistulas with antibiotics, but they may require surgery if they progress.
Anal fissures occur when tissues lining the anus, colon, or rectum tear, resulting in pain and rectal bleeding. In some cases, passing a hard stool may cause a tear.
When anal fissures occur, they may cause bright red blood when passing a bowel movement.
Warm baths, a high-fiber diet, and stool softeners may help reduce symptoms of fissures. In severe cases, fissures may require prescription creams or surgery.
4. Diverticular disease
These pockets are common and do not usually cause symptoms or require treatment unless they become infected.
Infected and inflamed diverticula may cause rectal bleeding, which can present itself in two ways:
- Diverticulitis with rectal bleeding: This may cause a moderate blood flow that lasts a few seconds and will usually stop on its own. It is also accompanied by other symptoms, such as abdominal pain, nausea, and fever.
- Diverticular bleeding: This is typically painless, with large volumes of blood coming from the rectum. It may result in a significant amount of blood loss.
Both presentations of diverticulitis warrant medical evaluation, especially diverticular bleeding. Doctors may treat diverticulitis with antibiotics and, in severe cases, surgery.
5. Proctitis or colitis
Proctitis occurs when the tissues of the rectum become inflamed, often resulting in pain and bleeding.
Treatments for proctitis and colitis vary depending on the causes. They range from antibiotics to surgery.
Common causes of proctitis and colitis include:
- some conditions that cause digestive problems, such as Crohn’s disease
- some medications, such as blood thinners
- radiation or chemotherapy
- anal intercourse
- reduced blood flow to the colon or rectum
- a blockage in the colon or rectum
Treatment for gastroenteritis usually involves fluids, rest, and antibiotics or antivirals, depending on the exact cause.
7. Sexually transmitted infections (STIs)
Unprotected sexual intercourse that involves the anal area may spread a wide range of viral and bacterial diseases. These may cause inflammation of the anus and rectum. Inflammation
Treatment for STIs usually involves either an antibiotic, antiviral, or antifungal medication based on the type of infection.
Weakened rectal tissues may allow a portion of the rectum to push forward or bulge outside of the anus, usually resulting in pain and, almost always, bleeding.
Typical treatment involves surgical intervention.
Polyps are noncancerous, abnormal growths. When polyps grow on the lining of the rectum or colon they may cause irritation, inflammation, and minor bleeding.
In many cases, a doctor will remove polyps during a routine colonoscopy screening.
10. Colon or rectal cancer
Cancer that impacts the colon or rectum can cause irritation, inflammation, and bleeding. Blood
Colon cancer is a very common form of cancer and tends to progress slowly, so it is often treatable if caught early.
Rectal cancer, while far rarer than colon cancer, is also usually curable if detected and treated in time.
Treatment may involve surgery or a combination of chemotherapy, radiation therapy, and surgery.
11. Internal bleeding
A person should see their doctor if they suspect internal rectal bleeding. The doctor will likely order a colonoscopy.
Occasional minor to mild rectal bleeding is common and may not require medical attention.
This may include streaks or drips of blood in the stool, the toilet bowl, or when wiping. Some people may also find blood in their underwear, or the toilet water may appear reddish-pink after they go to the bathroom.
However, severe, chronic, or painful rectal bleeding may be a sign of a more serious underlying condition that requires treatment.
Rectal bleeding may also cause bad-smelling, dark, tarry stools mixed with dark red to black blood. In some cases, it may also cause serious blood loss.
Reasons to see a doctor for rectal bleeding include:
- bleeding that lasts longer than a few days
- children with bloody stools
- unexplained weight loss, fatigue, or weakness
- painful, swollen, or tender abdomen
- accompanying fever, nausea or vomiting, or long-term constipation
- simultaneous lumps in the abdomen
- stool that is thinner, longer, or softer than normal for several weeks
- associated uncontrolled leakage from the anus
Reasons to seek emergency care for rectal bleeding include:
If bleeding is associated with an already diagnosed medical condition, a doctor will discuss ways to manage, reduce, and track symptoms.
If the cause of rectal bleeding is unknown, a doctor will normally ask questions about symptoms and the person’s medical history.
Depending on the severity, frequency, and accompanying symptoms, the doctor will work out if further testing is required. A doctor may also make a referral to a gastrointestinal or colorectal specialist.
Common tests associated with rectal bleeding include:
- a physical examination of the anus and rectum
- analysis of a stool sample
Specialists may perform additional tests, such as:
Treatment for blood in the stool or when wiping depends on the exact cause of the bleeding.
Common treatments include:
- topical creams or ointments
- eating more fiber
- procedures such as a colonoscopy, or, in some cases, surgery to remove part of the colon
A person should talk with a doctor about what treatment options work best for them.
In some cases, there is no real way to prevent minor cases of rectal bleeding. However, some factors are known to cause, contribute to, or worsen anal bleeding.
Common prevention tips for rectal, colon, and anal bleeding may include:
- eating a balanced diet that is high in fiber
- staying hydrated
- not straining when going to the washroom
- wiping the anus gently
- treating chronic or prolonged constipation with home or OTC remedies, such as stool softeners
- treating chronic or prolonged diarrhea with home or OTC remedies, such as bismuth subsalicylate
- trying not to lift heavy objects unless required
- maintaining a healthy body weight
- taking long, warm baths frequently if experiencing symptoms
- following treatment plans set out by a doctor for related medical conditions
- trying to avoid spicy, rich, fatty, heavily processed, and refined foods
- seeing a doctor about abnormal growths in the area
- avoiding overuse of nonsteroidal anti-inflammatory drugs (NSAIDs)
- wearing a condom during anal sex
It’s important to speak with a doctor about abnormal gastrointestinal symptoms, as these may be a sign of underlying conditions.
Blood that appears when wiping is typically caused by bleeding in the lower gastrointestinal (GI) tract. This includes the colon, rectum, and anus.
Bright red blood on paper is usually caused by hemorrhoids or anal fissures.
That said, a person may experience dark red or black blood in the stool, but not on the paper. This indicates the bleeding occurs further in the intestine.
If bleeding occurs, a person should consider seeing their doctor if it is severe, worsens, or continues for several days.
Why is there blood when I wipe?
Several underlying conditions may cause blood when a person wipes. The reasons can range from benign conditions, such as hemorrhoids or a minor injury, to much more severe conditions, like cancer.
Why is there a small amount of blood when wiping?
A small amount of blood
Many times, a small amount of blood in the stool or when wiping is not a reason for concern. However, in some cases, it could be something serious.
There are many causes of rectal symptoms. If a person finds blood when wiping or in the toilet after a bowel movement, it is a good idea to see a doctor to rule out any serious conditions.