Bleeding Per Rectum: Causes, Symptoms, and When to See a Doctor

Bleeding per rectum (BPR), often noticed as blood in stool or blood on toilet paper, is a common symptom that can feel alarming. While not always serious, it should never be ignored. Understanding the causes, associated symptoms, and when to seek medical help can make a significant difference in outcomes.

What Is Bleeding Per Rectum?

Bleeding per rectum refers to any blood that exits through the anus, originating from anywhere in the gastrointestinal (GI) tract—often the colon, rectum, or anus.
The blood may appear in different ways:

• Bright red blood – usually from the lower colon, rectum, or anus

• Dark red or maroon blood – may indicate bleeding from higher up in the colon

• Black, tarry stool (melena) – usually suggests bleeding from the upper GI tract

Common Causes of Bleeding Per Rectum

1. Hemorrhoids

One of the most frequent causes, hemorrhoids are swollen veins in the anus or rectum.
Typical features:

• Bright red blood

• Pain or itching

• Blood on toilet paper

2. Anal Fissures

Small tears in the anal lining, often due to hard stools or constipation.
Symptoms:-

• Sharp pain during bowel movements

• Bright red blood

3. Colorectal Polyps

Growths in the colon that may bleed. Some polyps can turn into cancer if untreated.

4. Inflammatory Bowel Disease (IBD)

Conditions like Ulcerative Colitis and Crohn’s Disease can cause inflammation and bleeding.
Associated symptoms: diarrhea, abdominal pain, weight loss.

5. Colorectal Cancer

Persistent rectal bleeding can be an early sign.
Other signs include: unexplained weight loss, change in bowel habits, fatigue.

6. Gastroenteritis or Infection

Bacterial infections may cause bloody diarrhea along with fever and cramps.

7. Diverticulosis / Diverticulitis

Small pouches in the colon can bleed or become infected.

Related Symptoms to Watch For

Bleeding alone offers clues, but accompanying symptoms help identify the cause:

• Pain during bowel movements

• Mucus in stool

• Diarrhea or constipation

• Unexplained weight loss

• Fatigue or weakness

• Abdominal discomfort

How Is Bleeding Per Rectum Diagnosed?

A healthcare provider may recommend:

• Physical/Rectal examination

• Stool tests

• Blood tests

• Colonoscopy or sigmoidoscopy

• Imaging studies (CT scan, ultrasound)

These help identify the site and cause of bleeding.

Treatment Options

Treatment depends on the underlying cause:

For Hemorrhoids

• High-fiber diet

• Warm sitz baths

• Topical creams

• Minimally invasive procedures if severe

For Anal Fissures

• Stool softeners

• Topical ointments

• Adequate hydration

For IBD

• Anti-inflammatory medications

• Lifestyle modifications

• Specialist care

For Polyps or Cancer

• Removal via colonoscopy

• Surgery

• Chemotherapy or radiation (depending on stage)

When Should You See a Doctor?

Seek medical attention if you experience:

• Persistent bleeding lasting more than a few days

• Large amounts of blood

• Black, tarry stools

• Severe abdominal pain

• Unexplained weight loss

• Fatigue or dizziness

• Bleeding along with a family history of colon cancer

Early diagnosis can prevent complications and improve outcomes.

Tips to Prevent Rectal Bleeding

• Eat a fiber-rich diet (fruits, vegetables, whole grains)

• Drink plenty of water

• Avoid prolonged straining during bowel movements

• Stay physically active

• Get regular colon cancer screenings, especially after age 45

Final Thoughts

Bleeding per rectum is not a disease in itself but a warning sign. While many causes are minor and treatable, others may require prompt medical care. Paying attention to your symptoms and seeking timely evaluation can ensure better digestive health and peace of mind.