Blood In Stool

Overview

Blood in your stool (your poo) means you see blood when you go to the toilet. It might be bright red on the toilet paper, in the water, or streaks on the stool. It can also look dark red, or black and sticky like tar. Blood in stool is a sign, not a diagnosis — it has many possible causes, and most of them are not serious. Still, it is always worth getting checked by a doctor, because a small number of causes need early treatment.

Yes, it is common. Many people see a little bright red blood at some point, often from piles or from straining when constipated. Because it is common, it is easy to ignore — but it is still worth mentioning to your doctor.

Anyone can get blood in their stool, at any age. It is more common in adults, in people who are pregnant, in people with constipation, and in older adults. In children, it is often caused by a small tear from a hard poo. In older adults, doctors check more carefully because the chance of other causes goes up with age.

Symptoms

Common symptoms

• Bright red blood on the toilet paper after wiping
• Blood in the toilet water, or streaks of blood on the surface of the stool
• Dark red or black, tarry-looking stools
• Itching, soreness or a small lump around the bottom
• Pain or a burning feeling when passing a poo
• Feeling like you still need to go, even after you have been
• Mucus (a jelly-like substance) mixed with the blood

Symptoms in children

• Small streaks of bright red blood on the toilet paper, often from a tiny tear caused by a hard poo
• Blood with hard, dry stools in a child who is constipated
• Blood-streaked mucus in nappies, which can happen with a tummy infection
• Red or dark stools caused by certain foods (such as beetroot or red food colouring) or iron supplements — this is not real bleeding, but it should still be checked
• In babies, blood in the nappy can sometimes be linked to a milk allergy or an infection — always tell your doctor or health visitor

Symptoms in older adults

• Blood from piles or from diverticular disease (small pouches in the bowel wall) is more common with age
• Bleeding can be more noticeable if you take blood-thinning medicines
• A change in bowel habit that lasts more than a few weeks, with or without blood, should be checked
• Tiredness or breathlessness alongside blood in the stool can be a sign of low iron (anaemia), so mention it to your doctor
• Bowel screening tests are offered to older adults in many countries — take part when invited

Causes

Main causes

• Piles (haemorrhoids) — swollen veins just inside or around the bottom, which can bleed when you strain
• Anal fissure — a small tear in the skin around the anus, often from passing a hard poo; it can be painful and leave bright red streaks
• Constipation and straining — hard stools can cause small amounts of bleeding
• Diverticular disease — small pouches in the bowel wall that can bleed, more common in older adults
• Bowel infections (gastroenteritis) — can cause bloody diarrhoea, often with cramping
• Inflammatory bowel disease — conditions such as Crohn's disease and ulcerative colitis, where the gut lining becomes inflamed
• Stomach or bowel ulcers, and inflammation of the stomach lining
• Growths in the bowel (polyps) — usually harmless, but some can develop into cancer over time
• Bowel cancer — much less common than the causes above, but this is why doctors take blood in the stool seriously
• Medicines and supplements — blood-thinning medicines can make bleeding more likely, and iron supplements can turn stools black

Risk factors

• A diet low in fibre, or not drinking enough fluids
• Long-term constipation or regularly straining on the toilet
• Pregnancy — pressure on the veins around the bottom makes piles more likely
• Being over 50 years old
• A family history of bowel cancer or bowel polyps
• Inflammatory bowel disease
• Taking blood-thinning medicines or some painkillers regularly
• Smoking, drinking a lot of alcohol, or being overweight
• Diverticular disease

When to see a doctor

See a doctor urgently if:

• Heavy or ongoing bleeding, or feeling faint, dizzy or cold
• Black tarry stools, or vomiting blood or coffee-ground material — call your local emergency number
• Bloody diarrhoea with a high temperature
• Severe belly pain
• Blood in the stool in a baby or young child

Book a routine appointment if:

• Any blood in your stool, even a small amount seen once
• Bright red blood that keeps coming back over weeks or months
• Blood with a change in bowel habit, such as going more often or looser stools
• Blood with mucus, or a feeling of not fully emptying your bowels
• Blood in the stool plus tiredness, breathlessness or looking pale
• A family history of bowel cancer — your doctor may suggest earlier checks even without symptoms

Diagnosis

Your doctor will start by asking questions: what the blood looks like, how much there is, how often it happens, and whether you have pain or a change in bowel habit. They will ask about your medicines and your family history. They may feel your tummy, and they may gently examine your bottom with a gloved finger to check for piles or a tear. Sometimes they will use a small tube with a light to look just inside. Depending on what they find, they may arrange tests or refer you to a specialist.

Tests that may be done

• A stool sample test to look for infection or hidden blood (in the UK this may be called a FIT test)
• Blood tests to check for anaemia (low iron) and to look at how your liver and kidneys are working
• A rectal examination — a quick, gentle check with a gloved finger
• Sigmoidoscopy — a short, thin flexible tube with a camera to look at the lower bowel
• Colonoscopy — a longer camera test that looks at the whole bowel; you are usually given sedation to keep you comfortable
• CT colonography — a scan that gives pictures of the bowel
• Testing for food allergies or coeliac disease in some children and adults

What to expect at your appointment

Most checks are quick and simple. The rectal examination takes seconds and is done privately behind a curtain. Camera tests usually need some preparation, such as drinking a special drink to clear the bowel, and you may be given sedation so you feel relaxed. You can usually go home the same day. Ask as many questions as you like before any test — it is your right, and it helps you feel in control.

Treatment

Treatment depends completely on the cause. Many people need only simple steps, such as eating more fibre, drinking more water and treating constipation. Others may need a cream, a procedure or, for some conditions, specialist care. Your doctor will explain which option suits you.

Self-care at home

• Eat more fibre — fruit, vegetables, wholegrains, beans and lentils — and increase it slowly
• Drink plenty of fluids, especially water, through the day
• Go to the toilet when you feel the urge; do not hold it in
• Avoid straining or sitting on the toilet for a long time, and avoid reading or scrolling on your phone there
• Clean gently after going — damp toilet paper or a gentle wash, then pat dry; avoid scrubbing
• Warm baths can soothe a sore bottom or a small tear
• Keep a simple note of when you see blood, what colour it is, and anything else you notice — this helps your doctor
• Do not take medicines for constipation or diarrhoea without asking a pharmacist or doctor first

Medical treatments

Your doctor may suggest creams or ointments to soothe piles and reduce swelling, or treatments to soften your stool if constipation is the cause. If an infection is found, it may be treated. If the cause is inflammation in the bowel or another long-term condition, you may be referred to a specialist who can discuss medicines that calm the inflammation. Some people have small procedures in clinic to treat piles, such as a tiny band placed around a pile to make it shrink. Your doctor or pharmacist will explain any treatment, including its benefits and possible side effects — always ask if anything is unclear.

When is surgery considered?

Surgery is only needed for some causes. Piles that keep causing problems can be treated with an operation. Polyps found during a camera test are usually removed at the same time, which is a routine part of the test. Some people with inflammatory bowel disease or bowel cancer may need surgery as part of their care. Your specialist team will talk through the options with you in detail.

Living with this condition

Try to keep things in perspective: for most people, blood in the stool has a treatable cause and settles with simple care. Keep a short diary of what you notice, go to your appointments, and follow any advice you are given. If you feel anxious while waiting for tests, talk to someone you trust — sharing worries really does help.

Lifestyle tips

• Build fibre into meals gradually so your gut has time to adjust
• Stay active — regular walking helps keep bowels moving
• Limit alcohol and avoid smoking
• Keep to a regular toilet routine, ideally at a calm time of day
• Avoid straining and long toilet sittings
• Take any prescribed treatment as explained, and ask your pharmacist if you are unsure

Diet and exercise

Aim for a balanced diet with plenty of fibre — wholegrain bread and cereals, fruit, vegetables, beans, lentils and nuts. Increase fibre slowly and drink enough fluid, or you may feel bloated at first. Most adults are advised to build up to around 30g of fibre a day, but any increase helps. Regular movement, such as a brisk walk most days, supports healthy bowels. If a particular food seems to trigger symptoms, mention it to your doctor rather than cutting out whole food groups on your own.

Mental health and emotional wellbeing

Seeing blood can be frightening, and waiting for test results can be an anxious time. It is very common to feel worried or to keep checking. Try to keep your normal routines, tell someone how you feel, and write down questions for your doctor. If worry is affecting your sleep, appetite or mood, tell your GP — support is available. If you ever feel you cannot cope, contact your local crisis line or emergency services.

Prevention

Some causes can be prevented or reduced, but not all. A high-fibre diet, plenty of fluids, regular activity and avoiding straining on the toilet all lower the chance of constipation, piles and small tears. These habits also support general bowel health. Other causes, such as inflammatory bowel disease or polyps, cannot be prevented by lifestyle alone — which is why screening and getting symptoms checked matter.

Screening programmes

Many countries run bowel cancer screening programmes. In the UK, people are invited to do a simple home stool test (called FIT) every two years, usually from around age 50 to 74 — the exact age range varies, so check your local programme. Screening can find problems early, sometimes before any symptoms appear. If you are invited, take part. If you have a strong family history of bowel cancer, tell your GP, as you may be offered earlier checks.

Complications

If left untreated

• Anaemia (low iron in the blood) from losing small amounts of blood over time, causing tiredness and breathlessness
• The underlying cause getting worse — for example, piles becoming painful or a small tear not healing
• A delay in diagnosing a more serious condition such as bowel cancer, when early treatment works best
• A pile that becomes swollen and painful (sometimes called a thrombosed pile)
• Ongoing worry and uncertainty, which can affect sleep and daily life

Long-term outlook

The outlook is good for most people. The most common causes — piles, small tears and constipation — usually settle with simple changes and treatment. Even when the cause is more serious, finding it early makes a real difference, and treatments continue to improve. The most important step is to get checked rather than wait. Whatever the cause, you deserve clear information and support, and your healthcare team is there to help.

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