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Is Bright Red Blood in Stool Serious?

Common causes of bright blood in the stool that are not serious include hemorrhoids, anal fissures, and abscesses. Bright red blood in the stool can be serious when it's due to diverticular disease inflammatory bowel disease (IBD), Crohn's disease, ulcerative colitis, polyps, ulcers, or colorectal cancer.
Common causes of bright blood in the stool that are not serious include hemorrhoids, anal fissures, and abscesses. Bright red blood in the stool can be serious when it's due to diverticular disease inflammatory bowel disease (IBD), Crohn’s disease, ulcerative colitis, polyps, ulcers, or colorectal cancer.

Bright red blood in the stool often originates from the lower intestine (colon), rectum, or anus and may be noticed when you see bright red blood in the toilet or on toilet paper after wiping following a bowel movement.

Bleeding may occur anywhere in the digestive tract from the mouth to the anus. The longer blood is in the digestive tract, the darker it can become, so darker blood in the stool usually originates from higher up in the digestive tract while bright red blood typically comes from the lower intestine (colon), rectum, or anus.

Common causes of bright blood in the stool that are not serious include: 

Causes of bright red blood in the stool that can be serious may include: 

It is important to see a doctor for any instance of blood in the stool, whether it is bright red or not, to diagnose the cause and receive proper treatment.

What Are Symptoms of Bright Red Blood in Stool?

Symptoms of blood in the stool include: 

  • Visible blood in the toilet after a bowel movement
  • Visible blood on toilet paper after wiping following a bowel movement
  • Red- or maroon-colored stool

Depending on the cause, symptoms that may accompany blood in the stool include:

  • Rectal pain
  • Rectal itching
  • Tissue bulging around the anus
  • Sensation of tearing, ripping, or burning pain during or after a bowel movement
  • Confusion
  • Fainting
  • Dizziness
  • Dehydration
  • Leakage of stool or difficulty cleaning after a bowel movement

How Is Bright Red Blood in Stool Diagnosed?

The cause of bright red blood in the stool is diagnosed with a patient history and physical exam that usually involves a rectal examination. 

Other rests to help diagnose the cause of bright red blood in the stool include 

  • Anoscopy to inspect the anal canal and lower rectum: this is usually an office procedure that does not require sedation
  • Sigmoidoscopy to examine the rectum and most of the lower large intestine
  • Colonoscopy to examine the entire colon
  • Esophagogastroduodenoscopy
  • Wireless capsule endoscopy 
  • Push enteroscopy
  • Double-balloon enteroscopy
  • Radionuclide scans
  • Angiography
  • Blood tests
    • Complete blood cell (CBC) count
    • Electrolyte levels
    • Coagulation profile

What Is the Treatment for Bright Red Blood in Stool?

Treatment for bright red blood in the stool depends on the cause. 

  • Hemorrhoids
    • Fiber supplements
    • Laxatives 
    • Warm sitz baths 
    • Topical pain-relieving creams and hydrocortisone rectal suppositories 
    • Surgery for severe cases
  • Anal fissures and abscesses
    • Fiber therapy
    • Laxatives 
    • Topical nifedipine and topical nitroglycerin 
    • Botulinum toxin 
    • Surgery for cases that persist despite other treatments
  • Polyps 
    • Surgical removal of polyps (polypectomy)
  • Inflammatory bowel disease (IBD)
    • Diet changes
    • Avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) which can irritate the stomach
    • Topical medications applied directly to the rectum such as 5-ASA (aminosalicylic acid or mesalamine)
    • Topical or oral steroid medications 
    • Oral 5-ASA 
    • Biologics
    • Intravenous steroids for severe cases
    • Other medications: tofacitinib or cyclosporine
  • Diverticular disease
    • Clear liquid diet for 2-3 days; progress to a soft diet as tolerated
    • 7-10 days of oral broad-spectrum antibiotics if needed
    • Acetaminophen (Tylenol) and antispasmodics for pain
    • In more severe cases, hospitalization may be needed
  • Ulcers
    • Antibiotics for H. pylori infection
    • Proton pump inhibitors (PPIs)
    • H2-receptor antagonists
    • Antacids 
    • Avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) which can irritate the stomach
  • Colorectal cancer 
    • Surgery to remove the part of the colon or rectum that has cancer
    • Chemotherapy
    • Radiation therapy

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References
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