Blood seen with bowel movements can come from a range of causes, from minor conditions to more serious problems. This page outlines likely causes, warning signs to watch for, and which medical specialties are typically involved in assessment.
Blood in stool can result from hemorrhoids, anal fissures, bacterial or viral infections, and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. Less commonly, sources include colonic polyps, diverticular disease, bleeding disorders, or bleeding higher in the gastrointestinal tract.
Bright red blood often points to bleeding in the rectum or anus, while dark, tarry stools (melena) suggest bleeding higher in the digestive tract. Whether blood is mixed with stool or appears on the surface can also help localize the source, but imaging and tests are needed for a definitive diagnosis.
A clinician will take a medical history and perform a physical and rectal exam. Depending on findings, tests may include stool analysis for infection, complete blood count, flexible sigmoidoscopy or colonoscopy, and imaging studies. The choice of tests is guided by symptom severity, bleeding characteristics, and associated signs.
Large amounts of bleeding, fainting or near-fainting, rapid heartbeat, severe abdominal pain, or difficulty breathing require immediate emergency assessment. For mild or intermittent bleeding, start with your primary care clinician; referrals are commonly made to Gastroenterology, Colorectal Surgery, or Infectious Diseases and Clinical Microbiology as needed.
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