Bleeding from the bottom (rectal bleeding)

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.

• 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

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

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.

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.

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)

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.

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

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.

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

Signs of bleeding from the bottom include blood on your toilet paper, blood on or in your poo, pink water in the toilet, or very dark poo.

If you see a GP because you have bleeding from your bottom, they may check your bottom with a gloved finger and ask for a sample of poo for testing.

Causes of bleeding from the bottom include piles, anal fissures, sexually transmitted infections and a side effect of medicine to prevent blood clots.