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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, smelly 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.

Non-urgent advice: 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

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

  • your poo is black or dark red
  • you have bloody diarrhoea for no obvious reason

You can call 111 or get help from 111 online.

Immediate action required: 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

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
Bright red blood and pain when pooing, itchy bottom, lumps Piles (haemorrhoids)
Bright red blood and pain when pooing – often after constipation A small tear in your anus (anal fissure)
Bleeding with or without lumps, itching or pain Sexually transmitted infections (STIs) like genital warts, damage from anal sex
Bright red blood without pain Side effect of blood-thinning medicine (anticoagulants) like warfarin 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
Blood and yellow slime when pooing, irritated anus, non stop bottom pain Anal fistula
Bloody diarrhoea with clear slime, feeling and being sick Tummy bug (gastroenteritis)
Bloody diarrhoea, tummy cramps and pain, feeling bloated An inflammatory bowel disease (IBD) like ulcerative colitis or Crohn's disease
Blood in poo Bleeding in the anus, bowel or lower gut from injury or another problem
Blood in poo, change in pooing habits (like looser poo, diarrhoea or constipation), slime with poo 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
Dark or black poo Bleeding in the stomach or gut – can be from injury or a side effect of blood-thinning medicine (anticoagulants) like warfarin or aspirin
Dark blood or poo with tummy pain or cramps Stomach ulcer, diverticular disease and diverticulitis
Dark blood without pain Blood-thinning medicine like warfarin or aspirin, angiodysplasia (broken blood vessels in the gut)

Page last reviewed: 24 April 2020
Next review due: 24 April 2023