Rectal Bleeding

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Try one of these related symptoms.

Bleeding from anus

Fresh blood from anus

About the Symptom

This is bright red blood passed from the anus.

When to See a Doctor

Seek professional care if you experience any of the following symptoms

Possible Causes

Generally, Rectal bleeding can be related to:

Related Serious Diseases

Sometimes, Rectal bleeding may be related to these serious diseases:

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

Reviewed By:

Mo Gerdvisheh, MD

Mo Gerdvisheh, MD (General Surgery)

Dr. Gerdvisheh is a Board Certified General Surgeon specializing in Minimally Invasive Surgery. He graduated Magna Cum Laude from Virginia Commonwealth University with a Bachelor of Science in Biology and Minor in Chemistry. He went on to earn his medical degree from Saba University School of Medicine and completed General Surgery residency at Mercy Health - Jewish Hospital. During his residency, he was awarded the Joel A. Essig Outstanding Resident Award as the most technically gifted and compassionate surgical resident. Dr. Gerdvisheh is also a graduate of the Harvard Medical School Surgical Leadership Program and holds positions on the Utilization Review, Credentialing, and Robotic Steering committee's at The Christ Hospital. He is committed to providing comprehensive care to his patients for a wide variety of surgical problems.

Yoshinori Abe, MD

Yoshinori Abe, MD (Internal Medicine)

Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.

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Content updated on Feb 6, 2025

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How Ubie Can Help You

With a free 3-min Rectal Bleeding quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.

This questionnaire is customized to your situation and symptoms, including the following personal information:

  • Biological Sex - helps us provide relevant suggestions for male vs. female conditions.

  • Age - adjusts our guidance based on any age-related health factors.

  • History - considers past illnesses, surgeries, family history, and lifestyle choices.

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FAQs

Q.

Is it a Hemorrhage? Why You’re Bleeding & Medically Approved Next Steps

A.

There are several factors to consider: a hemorrhage is heavy or uncontrolled bleeding, and warning signs include bleeding that will not stop after 10 to 15 minutes of pressure, blood in vomit or stool, black tarry stools, sudden severe headache, dizziness, fainting, confusion, or shock; small, controlled bleeding from minor cuts or hemorrhoids is usually not a hemorrhage. See below for medically approved next steps for minor wounds, rectal bleeding, and suspected internal bleeding, plus key risks like blood thinners, recent surgery, or pregnancy, and clear guidance on when to seek urgent care or call emergency services.

References:

* Ranucci M, Caimmi P, Di Dedda G, Gatta L, Lo Monaco F, Pellegatta R, Sirtori L, Zangrillo A. Acute severe bleeding: A practical guide for clinicians. J Intern Med. 2021 Apr;289(4):450-464. doi: 10.1111/joim.13217. Epub 2021 Jan 12. PMID: 33315264.

* Al-Samkari H, Connors JM. Approach to the Patient with Bleeding. Med Clin North Am. 2019 Mar;103(2):337-350. doi: 10.1016/j.mcna.2018.10.007. Epub 2018 Dec 20. PMID: 30704616.

* Butenas S. Physiology of Hemostasis. Transl Res Hemost. 2022;1(1):21-29. doi: 10.1002/trh2.12004. Epub 2021 Dec 28. PMID: 35059639; PMCID: PMC8753232.

* Spahn DR, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernandez-Mondéjar E, Filipescu D, Hunt BJ, Komadina R, Maegele M, Pazdernik L, Rossaint R, Santulli M, Schmidt M, Tinazzi E, Vincent JL, von Heymann C, Winstedt D, Zasa M. Management of massive hemorrhage in trauma: a practical overview. Minerva Anestesiol. 2019 Oct;85(10):1135-1150. doi: 10.23736/S0375-9393.19.13840-2. Epub 2019 Jul 29. PMID: 31359676.

* Sarani B, Kaplan A, Sakran JV, Shunkwiler S. Acute non-traumatic hemorrhage in the critically ill: a practical approach. Curr Opin Crit Care. 2019 Aug;25(4):421-427. doi: 10.1097/MCC.0000000000000627. PMID: 31219460.

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Q.

Dreading Colonoscopy Prep? Why It’s Vital and Your Medical Next Steps

A.

Colonoscopy prep is essential because a thoroughly clean colon lets your doctor see and remove polyps early, improving cancer detection and reducing the chance of repeat procedures. Your next steps are to schedule the exam, follow diet and split-dose prep instructions exactly, stay hydrated, and contact your doctor urgently for severe pain, heavy bleeding, persistent vomiting, or signs of dehydration. There are several factors to consider that may change your plan, including which clear liquids are allowed and ways to ease discomfort, so see below for important details.

References:

* Hassan C, et al. Patient Preferences for Colonoscopy Preparation: Systematic Review and Meta-analysis. Gastrointest Endosc. 2020 Dec;92(6):1184-1193.e3. doi: 10.1016/j.gie.2020.07.036. Epub 2020 Aug 3. PMID: 32742967.

* Rex DK, et al. Adequacy of Bowel Preparation in Older Adults Undergoing Screening and Surveillance Colonoscopy. Am J Gastroenterol. 2019 May;114(5):716-724. doi: 10.14309/ajg.0000000000000155. PMID: 30755913.

* Zhang X, et al. Effectiveness of Screening Colonoscopy in Reducing the Risk of Colorectal Cancer and Related Deaths: A Systematic Review and Meta-analysis. J Clin Oncol. 2023 Apr 1;41(10):1890-1901. doi: 10.1200/JCO.22.01633. Epub 2023 Feb 16. PMID: 36796306.

* Williams S, et al. Patient adherence to colonoscopy: what are the barriers and how can they be overcome? Ther Adv Gastroenterol. 2021 May 21;14:17562848211015340. doi: 10.1177/17562848211015340. PMID: 34045431; PMCID: PMC8135832.

* Kaminski MF, et al. Quality Indicators for Colonoscopy: From Preparation to Polypectomy. Dig Dis Sci. 2020 Nov;65(11):3102-3118. doi: 10.1007/s10620-020-06103-w. Epub 2020 Feb 24. PMID: 32098485; PMCID: PMC7017208.

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Q.

Bleeding on Plavix? Why Your Blood Reacts & Medically Approved Next Steps

A.

Bleeding on Plavix is common because it prevents platelets from clumping, so minor issues like nosebleeds, gum bleeding, or easy bruising can occur. Seek urgent care for black or bloody stools, vomiting blood, severe headache, stroke-like symptoms, blood in urine, or heavy bleeding that does not stop, and do not stop Plavix without medical advice. There are several factors to consider and medically approved next steps, including key risk factors, medication and lifestyle changes, and what your doctor may do to balance clot prevention with bleeding risk; see below for complete details that could shape your next steps.

References:

* Jain S, Gupta N, Kumar P, Kaur R, Sharma A, Sachdev N. Clopidogrel: Pharmacology, Pharmacokinetics, and Practical Considerations. Cardiovasc Ther. 2021 Mar 18;2021:6624933. doi: 10.1155/2021/6624933. eCollection 2021.

* Zucker N, Nouri N, Amir O, Shlomi R, Cohen D, Assali A, Lev EI. Management of bleeding complications in patients receiving P2Y12 receptor inhibitors. J Thromb Haemost. 2018 Jun;16(6):1038-1049. doi: 10.1111/jth.14022. Epub 2018 May 1.

* Singh G, Khurana D, Bansal R, Arora R, Jain G. Clopidogrel Resistance and Clinical Outcomes: A Critical Review. J Cardiovasc Transl Res. 2019 Jun;12(3):209-218. doi: 10.1007/s12265-019-09867-x. Epub 2019 Mar 1.

* Tomaselli GF, Mahaffey KW, Cuker A, Dabbous O, De Decker E, Eikelboom J, Granger CB, Guyatt G, Hill AF, Kaul S, Key NS, Marine JE, Morrow DA, Nattel S, Pollack CV Jr, Riley RF, Rubboli A, Shea JB, Vranckx P, Weitz JI, Wiviott SD, Zuffi A, Antman EM. 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants or Antiplatelet Agents: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2020 Aug 11;76(6):734-762. doi: 10.1016/j.jacc.2020.04.053. Epub 2020 Jun 25.

* Ma C, Lu Y, Sun J, Zhang F, Zhang S, Song Y. Risk factors for bleeding in patients treated with clopidogrel: a systematic review and meta-analysis. J Thromb Haemost. 2015 Nov;13(11):1989-2002. doi: 10.1111/jth.13110. Epub 2015 Sep 24.

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Q.

Scared of a Colonoscopy? Why Your Gut is Reacting & Medical Next Steps

A.

Feeling your stomach churn at the thought of a colonoscopy is a normal gut brain stress response, and the test is usually painless with sedation while powerfully preventing colorectal cancer by finding and removing polyps. Doctors recommend screening starting at age 45 or earlier with risk factors, and you should not delay if you have rectal bleeding, black stools, unexplained anemia, persistent bowel changes, severe abdominal pain, unintentional weight loss, or a strong family history. There are several factors to consider; see below for what actually happens during the procedure, how to manage prep and anxiety, and the exact next steps to take based on your symptoms and risk.

References:

* Li Y, Liu C, Wang C, Lu Y, Sun J, Zhang Y, Wang W. Psychological impact of colonoscopy on patients: A systematic review. J Adv Nurs. 2020 Sep;76(9):2289-2300.

* Varghese G, Chowdhury R, Maity S, Varghese P. The gut-brain axis: a primer for gastroenterologists. Int J Inflam. 2019 Jun 2;2019:2589574.

* Eames S, Lally RM, Lechner SC. Barriers and facilitators of colonoscopy screening uptake: a systematic review and thematic synthesis. J Cancer Surviv. 2021 Oct;15(5):714-727.

* Patel B, Feffer L, Parasa S, Thota PN, Burke CA. Strategies to Improve Colonoscopy Preparation: A Narrative Review. Am J Gastroenterol. 2020 May;115(5):663-672.

* Corley DA, Jensen CD, Marks AR, Levin TR, Schottinger JE, Udaltsova N, Fireman B, Assaf A, Barlow WE, Chubak J, Quinn VP, Kushi LH, Doubeni CA, Ghai NR, Zauber AG. Colorectal Cancer Screening: An Updated Review. JAMA. 2023 Feb 7;329(5):417-427.

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Q.

Worried About Clopidogrel? Why Your Body Reacts & Medically Approved Next Steps

A.

Clopidogrel prevents dangerous blood clots by reducing platelet clumping, so mild bruising or longer bleeding can occur, but warning signs like black or bloody stools, vomiting blood, severe headache with confusion, sudden weakness, chest pain, or trouble breathing require urgent care and you should not stop the medication without medical advice. There are several factors to consider. Interactions with NSAIDs, aspirin, PPIs or other blood thinners, age, ulcers, liver or kidney disease, alcohol use, and genetics can change risks; the medically approved next steps are to track symptoms, lower bleeding risks, and ask your doctor about alternatives, with complete details below.

References:

* Angiolillo DJ, Rollini F, Storey RF, Bhatt DL, James SK, Schneider DJ, Sibbing D, So DYF, Trenk D, Verheugt FWA, Antonino G, Angioli P, Zimarino M, Capodanno D. Personalized Antiplatelet Therapy Based on Pharmacogenomics and Platelet Function Testing: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018 May 15;71(19):2160-2178. doi: 10.1016/j.jacc.2018.03.486. Epub 2018 May 7. PMID: 29747970.

* Su G, Peng H, Shi J, Ding W, Ma G, Chen D, Tian X. CYP2C19 Polymorphisms and Clopidogrel Responsiveness: A Review. Curr Probl Cardiol. 2023 Apr;48(4):101569. doi: 10.1016/j.cpcardiol.2023.101569. Epub 2023 Jan 30. PMID: 36725350.

* Husted S. Beyond Clopidogrel: New Perspectives on Antiplatelet Therapy. Pharmaceuticals (Basel). 2020 Jan 29;13(2):22. doi: 10.3390/ph13020022. PMID: 32012695; PMCID: PMC7076997.

* Drozda K, Siller M, Koller L, Eder S, Ploner C, Mayer R, Larcher S, Steinacher-Schwarz B, Höpperger R, Schwienbacher C, Stix G, Würzner R, Jürgens G, Kress HG, Tilg H, Beer S. Clinical Implementation of Pharmacogenomics of Antiplatelet Agents. Front Pharmacol. 2021 Mar 15;12:646395. doi: 10.3389/fphar.2021.646395. eCollection 2021. PMID: 33790938; PMCID: PMC8004731.

* Angiolillo DJ, Rollini F, Capodanno D. High On-Treatment Platelet Reactivity and Personalized Antiplatelet Therapy: What We Know and Where We Are Going. J Cardiovasc Transl Res. 2024 Mar 22. doi: 10.1007/s12265-024-10497-2. Epub ahead of print. PMID: 38517228.

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Q.

Is Aspirin Safe? The Medical Reality & Your Approved Next Steps

A.

Aspirin is safe for many when used correctly, particularly for people with prior heart attack or stroke under a clinician’s guidance, but it is not risk free and can cause serious bleeding, including stomach and rectal bleeding. There are several factors to consider, like age, ulcer history, other medicines, alcohol use, pregnancy, and your reason for taking it, so see the important details below. Do not start or stop daily aspirin without medical advice, and seek urgent care for heavy bleeding, black stools, severe headache, chest pain, or stroke symptoms. For personalized next steps and how to weigh benefits versus risks, including what to do if you notice rectal bleeding, see below.

References:

* Mahmoud, A. N., Gaballa, M., Akbik, F., Al-Abdouh, A., Elgendy, I. Y., & Elgendy, A. Y. (2019). Aspirin for the primary prevention of cardiovascular disease: a meta-analysis. *Annals of Translational Medicine*, *7*(15), 346.

* Liu, Z., He, X., Wu, T., Shi, M., Tang, R., Wang, W., ... & Li, C. (2023). Low-dose aspirin for primary prevention of cardiovascular disease and its risks: a systematic review and meta-analysis. *Frontiers in Pharmacology*, *14*, 1184920.

* Wallace, J. L. (2018). Low-dose aspirin and gastrointestinal complications: current perspectives. *Pharmacology & Therapeutics*, *191*, 31-38.

* Roffi, M., Windecker, S., & Valgimigli, M. (2021). Aspirin in primary prevention: lessons from recent guidelines. *Current Opinion in Cardiology*, *36*(6), 661-667.

* Patrono, C., & Patrono, P. (2019). Aspirin in cardiovascular disease: what's new and what's next?. *Trends in Cardiovascular Medicine*, *29*(5), 263-269.

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Q.

Blood in Poop at 65: When to Worry and What to Do Next

A.

There are several factors to consider; at 65, blood in stool is common but not normal, with color and pattern offering clues, and causes ranging from hemorrhoids, anal fissures, diverticulosis, and medication related bleeding to polyps, colorectal cancer, inflammatory bowel disease, or upper GI bleeding. Act promptly: contact a doctor for recurrent or unexplained bleeding or if you are overdue for screening, and seek urgent care for heavy bleeding, clots, black tarry stools, dizziness, weakness or fainting, severe abdominal pain, shortness of breath, weight loss, or anemia; evaluation usually involves an exam, blood and stool tests, and colonoscopy, with treatment tailored to the cause and key next steps and prevention tips explained below.

References:

* Sartori, S., et al. Gastrointestinal Bleeding in the Elderly: A Systematic Review. *Current Gerontology and Geriatrics Research*, vol. 2018, 2018, pp. 1-13. https://pubmed.ncbi.nlm.nih.gov/30046399/

* Stollman N, Adnan H. Approach to Lower Gastrointestinal Bleeding in the Elderly. *Clin Geriatr Med*. 2018 Nov;34(4):539-555. https://pubmed.ncbi.nlm.nih.gov/30201103/

* Laine L, Jensen DM. Diagnosis and Management of Lower Gastrointestinal Bleeding. *Am J Gastroenterol*. 2020 Jan;115(1):29-41. https://pubmed.ncbi.nlm.nih.gov/31782211/

* Tsoi KKF, Ma TKL, Li X, Lau JYN, Sung JJY, Wu JCY. Risk factors for gastrointestinal bleeding in older adults: A systematic review and meta-analysis. *Am J Med*. 2015 Oct;128(10):1111-7.e1. https://pubmed.ncbi.nlm.nih.gov/25968140/

* Rex DK, Boland CR, Burt RW, Greene FL, Odze BS, Shike M, Wallace MB, White J. Colorectal Cancer Screening: Current Guidelines and Future Directions. *Gastroenterology*. 2020 Aug;159(2):493-504. https://pubmed.ncbi.nlm.nih.gov/32304918/

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Q.

Red Poop at 65+: When to Worry & 5 Causes Women Should Know

A.

Red or maroon stool after age 65 can be caused by harmless foods or supplements, but it can also point to problems that need care. The five common causes women should know are hemorrhoids, anal fissures, diverticular bleeding, colorectal polyps or cancer, and medication-related bleeding. There are several factors to consider; seek medical advice sooner if episodes recur, there is no food trigger, blood is mixed into stool, or you have weakness, dizziness, belly pain, weight loss, bowel habit changes, a history of colon disease, or you take blood thinners, and see the complete guidance below for when home monitoring is reasonable versus urgent evaluation.

References:

* Strate LL, Gralnek IM. Lower gastrointestinal bleeding in older adults: An updated review. Gastroenterology. 2016 May;150(6):1327-1338.e2. doi: 10.1053/j.gastro.2016.02.016. Epub 2016 Feb 25. PMID: 26922997.

* Tursi A, Scarpellini E, Pitocco D, et al. Diverticular Disease: From Epidemiology to Management. Front Pharmacol. 2021 Mar 1;12:656329. doi: 10.3389/fphar.2021.656329. eCollection 2021. PMID: 33737862.

* Fahey MT, O'Connell M, Cunningham D, et al. Colorectal cancer in older adults: an international perspective. J Geriatr Oncol. 2020 Jan;11(1):16-25. doi: 10.1016/j.jgo.2019.06.002. Epub 2019 Jun 15. PMID: 31213444.

* Begaj T, El-Masri R, Moinuddeen S, et al. Angiodysplasia of the gastrointestinal tract. World J Clin Cases. 2023 Jul 6;11(19):4498-4513. doi: 10.12998/wjcc.v11.i19.4498. eCollection 2023 Jul 6. PMID: 37456722.

* Theodorou G, Panou A, Katsi E, et al. Ischemic Colitis: A Review of Clinical Features, Diagnosis, and Management. World J Clin Cases. 2023 Nov 6;11(31):7395-7407. doi: 10.12998/wjcc.v11.i31.7395. eCollection 2023 Nov 6. PMID: 37986790.

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Q.

Rectal bleeding with bowel movements

A.

Rectal bleeding with bowel movements is common and often from hemorrhoids, anal fissures, or constipation, but the color and pattern can also point to inflammatory bowel disease, infections, or colorectal polyps and cancer; there are several factors to consider, and key details that could change your next steps are explained below. Seek urgent care for heavy or persistent bleeding, dizziness or weakness, black or maroon stools, severe abdominal pain, fever, or weight loss, and see below for how doctors evaluate, treat, and help prevent this.

References:

* Chang A, Dulai PS. Evaluation and Management of Anorectal Bleeding. Curr Treat Options Gastroenterol. 2019 Sep;22(3):288-297. doi: 10.1007/s11938-019-00236-0. PMID: 31214713.

* Darakjian L, Tejani MN. Approach to the Adult Patient With Rectal Bleeding. Clin Colon Rectal Surg. 2019 Jun;32(3):145-156. doi: 10.1055/s-0039-1681023. PMID: 31191062; PMCID: PMC6546306.

* Strate LL, Gralnek IM. Lower Gastrointestinal Bleeding: A Clinical Review. J Clin Gastroenterol. 2019 Jan;53(1):10-17. doi: 10.1097/MCG.0000000000001142. PMID: 30451733.

* Gung SY, Al-Mishlab T, O'Donnell S. Management of acute lower gastrointestinal bleeding: a narrative review. Ann Transl Med. 2022 Jul;10(14):795. doi: 10.21037/atm-22-2621. PMID: 36045952; PMCID: PMC9422079.

* Lim YJ, Ng KS, Liau CS. Haemorrhoids and Rectal Bleeding: Current Insights. Aust J Gen Pract. 2020 May;49(5):269-272. PMID: 32374971.

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Signify Health

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Penn State Health

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