Beyond Hemorrhoids: 9 Lesser-Known Causes of Rectal Bleeding

You go to the bathroom, and you’re surprised to find blood in your stool, on the toilet paper, floating in the water in the toilet bowl, or all three. And you wonder whether you should be concerned. 

There’s no easy answer to this question, but this does give the team board-certified colorectal surgeons at Fairfax Colon & Rectal Surgery an opportunity to discuss rectal bleeding in more detail. 

While hemorrhoids, which affect about half of people by age 50, are suspect Number One when it comes to rectal bleeding, it hardly stands alone. 

Color of blood matters 

Before we dive into some of the potential causes of anal bleeding, we first want to discuss an important distinction — the color of the blood. 

If you see bright red blood on your toilet paper, in the toilet bowl, or around the outside of your stool, this generally indicates a problem lower down in your digestive tract, including in your:

• Lower small intestine 
• Colon
• Rectum
• Anus

Conversely, if the blood is a darker red and it’s mixed in with your stool, this indicates an issue higher up in your digestive tract. This blood can also be described as thick and tarry, and the color can border on black. This darker blood usually points toward an issue higher up and in your:

• Small intestine
• Stomach
• Esophagus
• Mouth

When an issue occurs higher up your digestive tract, blood gets mixed in with stomach acids, which turns the blood darker. Then this darker blood gets mixed into your stool as it forms, as opposed to covering your stool after it has formed.

So, the first thing you want to figure out is the nature of the blood in your stool, which can really help narrow the possibilities.

The road to rectal bleeding

Now that we’ve created a division when it comes to rectal bleeding, we’re going to present the possible causes of this symptom and indicate the type of blood associated with each. So, outside hemorrhoids, these conditions also count rectal bleeding among their symptoms:

1. Anal fissures (bright red blood) 
2. Diverticulosis (bright red blood)
3. Constipation (bright red blood)
4. Anal fistulas (bright red blood)
5. Colon polyps, which occur in up to 40% of adults (bright red blood)
6. Gastrointestinal infections (both bright red and dark red blood)
7. Crohn’s disease (both bright red and dark red blood)
8. Ulcerative colitis (usually bright red blood)
9. Colorectal cancers, which affect more than 150,000 Americans each year (both bright red and dark red blood)

As you can see from this list, which ranges from constipation to cancer, there are many possibilities behind rectal bleeding — some serious, some not.

As well, bear in mind that these are just guidelines, and the only way to know for sure what’s causing your rectal bleeding is to come in for an evaluation with one of our colorectal experts.

To get that ball rolling, we invite you to schedule an appointment at any of our offices by clicking here.