Bleeding from the bottom (rectal bleeding) | 1st Choice Pharmacy Health Advice

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Bleeding from the bottom (rectal bleeding)

A small amount of one-off bleeding from the bottom is not usually a serious problem. But a GP can check.

Check if you're bleeding from the bottom

You might be bleeding from the bottom if you have:

blood on your toilet paper
red streaks on the outside of your poo
pink water in the toilet bowl
blood in your poo or bloody diarrhoea
very dark poo (this can be blood mixed in poo)

A small amount of one-off bleeding can often go away on its own without needing treatment.

See a GP if:

your child has blood in their poo
you've had blood in your poo for 3 weeks
your poo has been softer, thinner or longer than normal for 3 weeks
you're in a lot of pain around the bottom
you have a pain or lump in your tummy
you've been more tired than usual
you've lost weight for no reason

Ask for an urgent GP appointment or get help from NHS 111 if:

your poo is black or dark red
you have bloody diarrhoea

You can call 111 or get help from 111 online.

Go to A&E or call 999 if:

you're bleeding non-stop
there's a lot of blood – for example, the toilet water turns red or you see large blood clots

Find your nearest A&E

What happens at the GP appointment

If you have bleeding from your bottom, a GP will check what's causing it.

They might:

check your bottom (rectum) with a gloved finger (rectal examination)
ask for a sample of poo for testing
refer you to a specialist for tests

Bowel cancer risk

Bleeding from the bottom is sometimes a sign of bowel cancer.

This is easier to treat if it's found early, so it's important to get it checked.

Common causes of bleeding from the bottom

If you have other symptoms, this might give you an idea of the cause.

Do not self-diagnose. See a GP if you're worried.

Bright red blood on toilet paper, streaks on poo, pink toilet water

Possible causes of bright red rectal bleeding
Symptoms	Possible causes
Symptoms Bright red blood and pain when pooing, itchy bottom, lumps	Possible causes Piles (haemorrhoids)
Symptoms Bright red blood and pain when pooing – often after constipation	Possible causes A small tear in your anus (anal fissure)
Symptoms Bleeding with or without lumps, itching or pain	Possible causes Sexually transmitted infections (STIs) like genital warts, damage from anal sex
Symptoms Bright red blood without pain	Possible causes Side effect of medicine to help prevent blood clots like warfarin and apixaban (anticoagulants) or aspirin. Broken blood vessels in the gut (angiodysplasia)

Blood in poo or blood with slime

Poo can look like it's mixed with blood if you've eaten a lot of red or purple foods like tomatoes and beetroot.

But it's sometimes a sign of something else. A GP can check if you're worried.

Possible causes of slime or blood in your poo
Symptoms	Possible causes
Symptoms Blood and yellow slime when pooing, irritated anus, non stop bottom pain	Possible causes Anal fistula
Symptoms Bloody diarrhoea with clear slime, feeling and being sick	Possible causes Tummy bug (gastroenteritis)
Symptoms Bloody diarrhoea, tummy cramps and pain, feeling bloated	Possible causes An inflammatory bowel disease (IBD) like ulcerative colitis or Crohn's disease
Symptoms Blood in poo	Possible causes Bleeding in the anus, bowel or lower gut from injury or another problem
Symptoms Blood in poo, change in pooing habits (like looser poo, diarrhoea or constipation), slime with poo	Possible causes Bowel polyps, early signs of bowel cancer

Very dark or black blood or poo

Poo can look very dark or black if you:

take iron tablets
eat a lot of dark foods like liquorice and blueberries

But it's sometimes a sign of something else. A GP can do a test to check this if you're worried.

Possible causes of very dark or black blood coming from your bottom
Symptoms	Possible causes
Symptoms Dark or black poo	Possible causes Bleeding in the stomach or gut – can be from injury or a side effect of medicine to help prevent blood clots like warfarin and apixaban (anticoagulants) or aspirin
Symptoms Dark blood or poo with tummy pain or cramps	Possible causes Stomach ulcer
Symptoms Dark blood without pain	Possible causes Side effect of medicine to help prevent blood clots like warfarin and apixaban (anticoagulants) or aspirin