What Do Red Spots in Your Poop (Hematochezia) Mean?

Red spots in poop (hematochezia) can signal a wide range of causes, such as anal fissures, hemorrhoids, and, although rare, cancer. There are differences between hematochezia and melena. Hematochezia includes bright red or dark red and brown stools that signal bleeding in the digestive tract. Melena means black, tar-like stool that indicates bleeding in the stomach.

If you notice blood in your stool, take note of a few things. Consider how much blood you see, the color of the blood, and whether it's mixed in with the stool or floating on top. These details can help a healthcare provider pinpoint the source of the bleeding.

Most causes of rectal bleeding, or hematochezia, are not life-threatening or urgent. However, it's still important to bring any bloody stool concerns to the attention of a healthcare provider right away. Read on to learn about the most common causes of blood in the stool.

What Does Blood in Stool Look Like?

Stool blood that's bright red is usually coming from the large intestine (colon), rectum, or anus. Dark-red or brown stools could be due to blood being higher up in the digestive system, in the small intestine. Stools that appear black, or melena, are typically the result of bleeding in the stomach.

Eating certain foods can also affect stool color. You might notice red stool after eating beets or foods made with red food coloring. This doesn't mean that you have blood in your stool.

Causes

Blood in the stool typically indicates that there's bleeding in the digestive tract, such as the small intestine, colon, rectum, or anus. You may notice blood in your stool or on toilet paper. Blood is not always visible, so a healthcare provider can use tests to detect bleeding.

Anal Fissures

You may have a tear in the anus itself, or an anal fissure, if you notice bright red blood covering the surface of the stool. Anal fissures can cause bleeding and a sensation of tearing, ripping, or burning pain during or after a bowel movement.

Anal fissures can be painful, but the cuts are typically nothing to worry about. These tears heal on their own within a few weeks.

Angiodysplasia

Angiodysplasia causes swollen blood vessels in the colon or small intestine, which can cause bleeding. The blood vessels in the digestive tract break down with age, so this condition is most common in older adults.

Blood Thinners

Blood thinners are a type of medication that prevents blood clots or stops them from getting bigger. Blood clots can increase the risk of a heart attack and stroke. These medications may cause bleeding in the digestive tract, which you may see in your stool.

Diverticular Disease

People with diverticular disease have small, bulging pouches in the lining of the colon (diverticula). This condition is most common in older adults, but the exact cause is unclear. The diverticula can bleed or become inflamed or infected, causing blood in the stool.

Esophageal Problems

Some people can develop varices in the esophagus, which connects the throat to the stomach. These enlarged veins can rupture and bleeding, which may cause bloody, black, or tar-like stools. Varices are most common in people with cirrhosis (scarring) of the liver, which reduces blood flow through the liver.

Endometriosis

Endometriosis causes tissue that resembles the inner uterine lining to grow outside the uterus. This abnormal tissue growth, or lesions, can develop on the fallopian tubes, ovaries, or deep in the bowel. Lesions can swell and bleed, similar to the inner uterine lining, during the menstrual cycle.

The most common endometriosis symptoms are pelvic pain and painful periods. People with bowel endometriosis may also notice blood in the stool.

Gastroenteritis

Gastroenteritis is a bacterial or viral infection of the digestive tract. An infection caused by bacteria like E. coli or salmonella can cause bloody diarrhea. Other symptoms include nausea and vomiting. The most common way these bacteria are transmitted is through contaminated food or water.

Hemorrhoids

Blood on your poop or bleeding during or between bathroom runs could be a sign of hemorrhoids. These swollen blood vessels in the rectum or anus can be painful, itchy, and sometimes bleed. People with hemorrhoids often have painless rectal bleeding. Bright red blood may coat the stool after a bowel movement, drip into the toilet, or stain toilet paper.

You can develop hemorrhoids from a variety of causes, including:

• Chronic constipation or diarrhea
• Frequently lifting heavy objects
• A low-fiber diet
• Sitting on the toilet for long periods
• Straining during bowel movements
• Weakening of the supporting tissues in the anus and rectum, which can happen with aging and pregnancy

IBD and Inflammation of the Digestive Tract

Blood in the stool can also be a sign of inflammatory bowel disease (IBD). IBD is a group of digestive disorders, which includes Crohn's disease and ulcerative colitis (UC).

Crohn's disease involves inflammation anywhere in the digestive tract. UC causes inflammation that affects the lining of the colon and rectum. Inflammation can cause small sores (ulcers) to form in these areas. These sores can join together and become large ulcers that bleed, resulting in bloody stools.

Peptic Ulcer

A peptic ulcer forms in the lining of the stomach or the upper part of the small intestine (duodenum). Some ulcers can bleed, causing blood in the stool. The most common reason people develop peptic ulcers is a bacterial infection caused by H. pylori, which spreads through contaminated food and water.

Sexually Transmitted Infection (STI)

Sexually transmitted infections (STI) may cause proctitis, or inflammation of the rectum. Some of the most common causes include chlamydia and gonorrhea. Symptoms can include rectal bleeding, discharge of mucus or pus, and pain. You might notice bloody stools if you have rectal bleeding.

Cancer

Rectal bleeding can also result from cancerous or pre-cancerous conditions, although it's rare. It's especially important to bring any bloody stool concerns to the attention of a healthcare provider right away.

The good news is that polyps can be removed very safely from the colon, preventing progression to cancer. Colorectal cancer can often be treated if it's diagnosed early.

Causes in Children

The most common cause of bloody stool in children is constipation. Constipation, or fewer than three bowel movements per week, may result in anal fissures that cause bleeding.

Other causes of bloody stool in children include:

• Food allergies
• Infections
• IBD
• Meckel's diverticulum, or bulging tissue in the small intestine that's congenital (present at birth)
• Ulcers

Diagnosis

A healthcare provider will ask about your health history and examine your abdomen and rectum. They can work with you to help determine the underlying cause and the best course of treatment.

You may require one or more of the following tests to confirm a diagnosis:

• Angiography: A healthcare provider will inject a special dye into blood vessels that supply the small intestine and colon. The dye makes bleeding visible on an X-ray or CT scan.
• Anoscopy: This test uses an anoscope, which is a small device with a magnifier, to examine the anal canal.
• Bleeding scan: This scan detects red blood cells and how they're moving in your body.
• Colonoscopy or sigmoidoscopy: A healthcare provider may use one of these tests to examine the colon. Both tests use a thin tube with a camera to look inside the colon.
• Digital rectal exam: A healthcare provider will insert a gloved finger into the rectum to detect abnormalities.
• Lab tests: These tests may include a complete blood count (CBC) or a stool sample, which can detect markers of disease.

Treatment

Some cases of blood in the stool go away on their own, while others require treatment. Treatment will depend on the underlying cause.

Antibiotics, for example, can treat a bacterial infection like gastroenteritis or H. pylori, which causes peptic ulcers. Surgery can remove benign (non-cancerous) or cancerous polyps. A healthcare provider can help determine the best course of treatment.

Home remedies that may ease rectal bleeding include:

• Eat a high-fiber diet and stay hydrated, both of which can alleviate constipation that causes anal fissures and hemorrhoids.
• Take a sitz (shallow and warm) bath.
• Use a hemorrhoid cream, which is available over the counter.

When To See a Healthcare Provider

It's a good idea to see a healthcare provider, even if you think hemorrhoids are causing the blood in your stool. Consult a healthcare provider right away if you have:

• A change in the color of your stools
• Drop in blood pressure that causes dizziness or fainting
• Fresh blood in your stools
• Incontinence or lack of control over the passage of stools
• Pain in the anal area while sitting or passing stools
• Unexplained weight loss

A Quick Review

There are a few possible reasons for blood in your stool, from anal fissures and hemorrhoids to IBD and cancer. The bottom line is: Reach out to a healthcare provider as soon as possible if you notice blood in your poop, in any amount. They can administer tests to rule out or confirm a diagnosis.

A healthcare provider may recommend home remedies for minor causes like anal fissures and hemorrhoids. These remedies include a sitz bath or creams. Causes like IBD, peptic ulcers, and cancer may require medication or surgery.