Rectal bleeding

About rectal bleeding

If you have been bleeding fresh (red) blood from your back passage (rectum) which does not happen at the same time as opening your bowels (passing faeces or poo), you will need an assessment from a healthcare professional.

It is important that you follow the advice you have already been given if this is happening to you.

Bleeding from your back passage when you go to the toilet to pass faeces (poo) can happen for many different reasons. This type of bleeding is known as rectal bleeding.

There are a number of reasons for rectal bleeding, these include:

  • constipation
  • haemorrhoids (piles)
  • anal fissure (a small tear in the opening of the anus)
  • rectal trauma (for example an injury caused by accident or sexual assault)
  • polyps
  • stomach or duodenal ulcers
  • infections of the gut (stomach)
  • gastrointestinal bleeding (such as that caused by diverticular disease or bowel cancer)
  • long-term conditions, such as Crohn’s disease or ulcerative colitis

The amount of blood lost can vary but is usually light and will come and go. Often the amount of blood lost may look worse than it actually is.

The colour of your blood can indicate where in the gastrointestinal system the bleeding may be coming from. For example fresh (bright red) blood can show that the bleeding is coming from lower in the bowel (nearer to the back passage or anus) – which is usually a sign of haemorrhoids, fissures or other localised conditions.

Bleeding in your large bowel (colon) can be fresh (red) or a darker colour of blood (dark red) and mixed in with your faeces (poo). One of the causes can be polyps, which are growths on the bowel wall. Polyps are usually harmless but some types can turn into more serious conditions like cancer, so will always require investigating and further assessment from a healthcare professional.

Stools (poo) which look like tar, are black and have a very bad smell, may suggest a problem higher up in the gastrointestinal system, such as an ulcer in the stomach or duodenum.

It is very important that any bleeding from the gastrointestinal system is checked by a healthcare professional. Further assessments and tests may be needed to establish the cause of the problem.

In the meantime, the information below may help you to look after yourself.

Looking after yourself

If you have rectal bleeding there are a number of things you can do to help manage the condition. Here is some self care information:

A common cause of rectal bleeding is constipation and this can lead to haemorrhoids (piles) and anal fissures.

This advice may help you deal with constipation and help prevent it:

  • Drink 8-12 glasses of clear fluid a day (water is best) unless you have an existing medical condition which means this is not possible. Avoid caffeine, fizzy drinks and alcohol.
  • Eat fibre-rich foods, such as bran cereals, fruit and vegetables and whole grain bread, which will help soften your stools (poo).
  • Avoid processed foods, such as white bread and cheese.
  • Keeping active and mobile reduces the risk of getting constipated. Children should be encouraged to get lots of active play.
  • Don't put off the urge to go to the toilet.

Anal care

  • Keep your anal area clean by washing with soap and water every day. This will help to reduce the bacteria around your anus.
  • Avoid vigorous wiping with toilet paper as this may cause further chafing of your skin, which can become infected or inflamed.
  • A cold compress – such as a cold flannel or an ice pack can help relieve pain and swelling. You can make an ice pack from a bag of frozen peas wrapped in a tea towel, which you can refreeze as many times as you like, but do not eat the contents after they have defrosted. Do not keep the ice pack on the area for more than 15-20 minutes.
  • Try not to strain when going to the toilet as this can increase the irritation in your anal area and lead to more serious complications, such as haemorrhoids (piles).
  • To help relieve pain and discomfort from anal irritations, sit in 8-10 inches of warm water for 10-20 minutes, several times a day if possible.
  • Over-the-counter creams, lotions and ointments may also be used to relieve itching around the anal or rectal area. Follow the instructions for use or ask your pharmacist for advice.
  • If you are in pain, get advice on medicines you can take.
 

Useful links

Anal fissure - NHS Choices
Anal fistula - NHS Choices
Diverticular disease and diverticulitis - NHS Choices
Bowel cancer - NHS Choices
Bowel cancer UK
Rectal bleeding (blood in faeces) - Patient UK