What are the reasons for red-colored stool. How can you differentiate between benign causes and serious health concerns. When should you consult a doctor about red stools. What treatments are available for various causes of red stool.

Understanding the Causes of Red Stool

Noticing red coloration in your stool can be alarming, but it’s important to understand that not all causes are serious. Red stool can result from various factors, ranging from benign dietary choices to more concerning medical conditions. Let’s explore the common causes and when you should be concerned.

Dietary Causes of Red Stool

Often, red stool is simply the result of consuming certain foods or substances:

• Red-colored foods: Beets, tomatoes, and red-colored foods can tint stool red
• Food dyes: Artificial coloring in foods and drinks may alter stool color
• Medications: Bismuth subsalicylate (found in some antacids) can cause a reddish tint

These dietary causes are typically harmless and resolve once the food or substance is no longer consumed.

Hemorrhoids: A Common Culprit of Red Stool

Hemorrhoids are a frequent cause of red stool, affecting nearly 5% of the U.S. population, particularly those between 45 and 65 years old. But what exactly are hemorrhoids?

Hemorrhoids are swollen veins in the rectum and anus. They can be internal (inside the rectum) or external (around the anus). When irritated, they may bleed, causing bright red streaks on toilet paper or in the toilet bowl.

Symptoms of Hemorrhoids

• Painful bowel movements
• Blood in stool or when wiping
• Itching or discomfort around the anus
• A noticeable lump near the anus

Hemorrhoids are often exacerbated by constipation. The strain of passing hard stools can irritate these swollen veins, leading to bleeding. Pregnancy is another common cause of hemorrhoids due to increased pressure in the pelvic area.

Managing Hemorrhoids

How can hemorrhoids be managed or treated? Several approaches can help:

1. Dietary changes: Increasing fiber intake and staying well-hydrated can soften stools and reduce straining
2. Over-the-counter treatments: Hemorrhoid creams can help manage symptoms
3. Sitz baths: Sitting in warm water can soothe discomfort
4. Medical interventions: In severe cases, surgical removal may be necessary

Anal Fissures: Another Source of Red Stool

Anal fissures are small tears in the lining of the anus. They affect about 11% of people at some point in their lives. These fissures can cause bright red bleeding during bowel movements.

Causes of Anal Fissures

What leads to the development of anal fissures? Several factors can contribute:

• Constipation and passing hard stools
• Bouts of diarrhea
• Anal sexual activity
• Childbirth

Treating Anal Fissures

Most anal fissures heal on their own with proper care. Treatment options include:

1. Sitz baths to soothe the area
2. Stool softeners or laxatives to ease bowel movements
3. Topical medications prescribed by a doctor for persistent fissures

Gastrointestinal Bleeding: A More Serious Concern

While hemorrhoids and anal fissures are common and generally benign causes of red stool, gastrointestinal (GI) bleeding is a more serious condition that requires medical attention.

Understanding GI Bleeding

GI bleeding can occur anywhere along the digestive tract, from the esophagus to the anus. The color and consistency of the blood in the stool can provide clues about the location of the bleeding:

• Bright red blood usually indicates lower GI tract bleeding
• Dark, tarry stools may suggest upper GI tract bleeding

Symptoms of GI Bleeding

GI bleeding often comes with additional symptoms beyond just red stool:

• Nausea or vomiting
• Lightheadedness or dizziness
• Fatigue or weakness
• Abdominal pain

If you experience these symptoms along with red stool, it’s crucial to seek immediate medical attention.

Inflammatory Bowel Disease and Red Stool

Inflammatory Bowel Disease (IBD), which includes conditions like Crohn’s disease and ulcerative colitis, can also cause red stool. These chronic conditions involve inflammation of the digestive tract.

Symptoms of IBD

IBD can cause a range of symptoms, including:

• Persistent diarrhea
• Abdominal pain and cramping
• Fatigue
• Unintended weight loss
• Blood in the stool

Diagnosing and Treating IBD

Diagnosing IBD typically involves a combination of physical exams, lab tests, imaging studies, and endoscopic procedures. Treatment aims to reduce inflammation and manage symptoms, often involving medications, dietary changes, and in some cases, surgery.

Colorectal Cancer: A Rare but Serious Cause of Red Stool

While less common, colorectal cancer can sometimes cause red stool. It’s important to be aware of this possibility, especially for individuals over 50 or those with a family history of colorectal cancer.

Risk Factors for Colorectal Cancer

Several factors can increase the risk of colorectal cancer:

• Age (risk increases after 50)
• Family history of colorectal cancer
• Personal history of polyps or IBD
• Lifestyle factors like smoking, heavy alcohol use, and lack of physical activity

Screening and Early Detection

Regular screenings are crucial for early detection of colorectal cancer. The American Cancer Society recommends that people at average risk start regular screenings at age 45. Screenings may include:

1. Stool-based tests
2. Visual exams of the colon and rectum
3. Colonoscopy

When to Seek Medical Attention for Red Stool

While many causes of red stool are benign, certain symptoms warrant immediate medical attention. When should you consult a doctor about red stool?

• If red stool persists for more than a few days
• If you experience severe abdominal pain, fever, or vomiting
• If you feel dizzy, weak, or faint
• If you’re losing weight unintentionally
• If you have a family history of colorectal cancer

Remember, it’s always better to err on the side of caution when it comes to your health. If you’re unsure about the cause of your red stool or if you’re experiencing additional concerning symptoms, don’t hesitate to seek medical advice.

Diagnostic Approaches for Red Stool

How do doctors determine the cause of red stool? The diagnostic process may involve several steps:

Medical History and Physical Examination

Your doctor will likely start by asking about your symptoms, diet, and medical history. They may also perform a physical exam, including a digital rectal examination.

Stool Tests

Various stool tests can provide valuable information:

• Fecal occult blood test: Detects hidden blood in the stool
• Stool culture: Checks for infectious causes of diarrhea
• Fecal calprotectin test: Can indicate inflammation in the intestines

Imaging Studies

Depending on the suspected cause, your doctor may recommend imaging studies such as:

• Colonoscopy: Allows direct visualization of the entire colon
• Flexible sigmoidoscopy: Examines the lower part of the colon
• CT scan or MRI: Can provide detailed images of the digestive tract

Blood Tests

Blood tests can help assess overall health and check for signs of anemia, infection, or inflammation.

Treatment Options for Red Stool

Treatment for red stool depends on the underlying cause. What are some common treatment approaches?

Dietary Changes

If red stool is due to dietary factors, simply avoiding the offending foods or substances may resolve the issue. For conditions like hemorrhoids or anal fissures, increasing fiber intake and staying hydrated can help prevent recurrence.

Medications

Depending on the cause, your doctor may prescribe:

• Anti-inflammatory drugs for IBD
• Antibiotics for bacterial infections
• Stool softeners or laxatives for constipation

Surgical Interventions

In some cases, surgery may be necessary:

• Hemorrhoidectomy for severe hemorrhoids
• Polyp removal during colonoscopy
• Surgical resection for colorectal cancer

Lifestyle Modifications

Certain lifestyle changes can help manage and prevent recurrence of conditions causing red stool:

• Regular exercise
• Stress management techniques
• Quitting smoking
• Limiting alcohol consumption

Remember, the appropriate treatment will depend on the specific cause of your red stool. Always consult with a healthcare professional for personalized advice and treatment plans.

Preventing Red Stool and Maintaining Digestive Health

While not all causes of red stool are preventable, there are steps you can take to maintain your digestive health and reduce the risk of certain conditions. How can you promote good digestive health?

Dietary Considerations

A balanced diet plays a crucial role in digestive health:

• Eat plenty of fiber-rich foods like fruits, vegetables, and whole grains
• Stay hydrated by drinking adequate water throughout the day
• Limit processed foods and excessive red meat consumption
• Consider probiotic-rich foods or supplements to support gut health

Regular Exercise

Physical activity can help maintain healthy bowel function. Aim for at least 30 minutes of moderate exercise most days of the week.

Stress Management

Chronic stress can negatively impact digestive health. Incorporate stress-reduction techniques into your routine, such as:

• Meditation or mindfulness practices
• Yoga
• Deep breathing exercises
• Regular leisure activities

Regular Health Screenings

Stay up-to-date with recommended health screenings, especially for colorectal cancer. These may include:

• Regular colonoscopies starting at age 45 for average-risk individuals
• Fecal occult blood tests
• Stool DNA tests

By adopting these healthy habits and staying vigilant about your digestive health, you can potentially reduce the risk of conditions that cause red stool and promote overall well-being.

Remember, while red stool can be alarming, in many cases it’s not a cause for immediate concern. However, persistent or recurring red stool, especially when accompanied by other symptoms, should always be evaluated by a healthcare professional. Your health is paramount, and timely medical attention can make a significant difference in diagnosing and treating any underlying conditions.

5 Reasons Your Stool is Red

1. Gastrointestinal & Buttocks

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2. Red Stool

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Red stool can be a symptom of internal bleeding and may come with uncomfortable symptoms.

Written by

Shria Kumar, MD.

Therapeutic Endoscopy Fellow, MD Anderson Cancer Center, Houston, TX

Last updated February 8, 2021

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What’s causing your red stool

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Written by

Shria Kumar, MD.

Therapeutic Endoscopy Fellow, MD Anderson Cancer Center, Houston, TX

Last updated February 8, 2021

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Red stool may be caused by a red food you eat, like beets, or may also be caused by bleeding in your lower GI tract. Causes of the bleeding could be somewhat superficial like a hemorrhoid, anal fissure, or abbrasians, or signs of inflammation in your bowels, bleeding in your stomach or intestines, or colon cancer.

5 most common causes

Anal Fissure

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What’s causing your red stool

Seeing reddish stool in the toilet after a bowel movement can be disconcerting. But often it’s caused by red food (tomatoes and beets), dyes, and over-the-counter products. In particular, bismuth, an ingredient in antacids like Pepto-Bismol, might give stool a reddish tint.

But it can also be a sign that you’re bleeding. Bright red streaks on toilet paper or in the toilet may be caused by hemorrhoids or anal fissures, especially when accompanied by anal pain or itching. Or an inflammation in the intestines, from inflammatory bowel disease.

Red stool may also be caused by internal bleeding in the digestive tract, and in some cases, colon cancer. If red stool is accompanied by symptoms like fever, abdominal or rectal discomfort, weight loss, nausea, diarrhea, or vomiting, or blood seems clumpy like coffee grounds or uncontrollable after elimination, call a doctor.

Pro Tip

If you have reddish stools, the most important thing is to figure out why. If it is not clearly related to your diet, if you have other health issues, your doctor will do a workup. —Dr. Shria Kumar

Causes

1. Hemorrhoids

Symptoms

• Painful elimination
• Blood in stool or blood while wiping
• Pain or itching around the anus
• Feeling a lump near the anus

Hemorrhoids are swollen veins around the rectum and anus. They occur in nearly 5% of the U.S. population, and occur most commonly in people between 45 and 65.

They are often inflamed by constipation. When you’re constipated, straining to eliminate can irritate the hemorrhoids and cause them to bleed. Pregnancy can also cause hemorrhoids.

Using laxatives, staying well hydrated, and eating a high fiber diet can help relieve constipation.

Hemorrhoid cream can help you manage symptoms. In some cases, hemorrhoids may have to be surgically removed.

2. Anal fissure

Symptoms

• Constipation
• Pain in the rectum, particularly while passing stool
• Hard stool
• Bloody stool or blood when wiping

Anal fissures are splits or tears in the part of the anus just outside of the body. They’re very common—about 11% of people will have an anal fissure in their lifetime. They can occur after a bout of diarrhea or from constipation. Anal fissures can also occur because of anal sexual activity that may cause mild trauma to the anus, or from trauma to the anal area during childbirth.

Anal fissures usually get better on their own, but you may take laxatives to make passing stool less painful. Sitz baths (sitting waist deep in a bath of warm water, sometimes with baking soda added for additional soothing) can also help relieve the discomfort. Occasionally, a doctor may prescribe medication if the fissure doesn’t get better on its own.

3. GI bleeding

Symptoms

• Bleeding from the rectum
• Nausea
• Lightheadedness
• Fatigue
• Bloody stool

The digestive, or gastrointestinal (GI), tract includes the esophagus, stomach, small intestine, large intestine, rectum, and anus. In general, gastrointestinal bleeding does not just lead to reddish stool, but frank blood is seen (can be with clots), and is accompanied by other symptoms (such as abdominal pain, fatigue, lightheadedness, and weight loss).

GI bleeding that causes red stool is usually lower GI bleeding (from the large intestine, rectum, or anus), but really rapid upper GI bleeding can also cause it. Depending on its severity, it can be a medical emergency.

Causes of lower GI bleeding include diverticulosis, colitis, inflammatory bowel disease, colon polyps, or colon cancers. The treatment is targeted to the underlying cause.

4. Inflammatory bowel disease (Crohn’s or colitis)

Symptoms

• Fatigue
• Fever
• Bloody diarrhea
• Weight loss
• Mouth sores
• Joint pains

Inflammatory bowel disease (IBD) is inflammation of the bowel. There are two types: Crohn’s disease or ulcerative colitis. It is caused by a complex interplay between genetics, the environment, and your body’s immune system. Early symptoms may develop gradually, or can occur suddenly.

Untreated, IBD causes inflammation throughout the digestive tract, which can lead to malnutrition, cancers, bleeding, and overall poor health. The goal of treatment is to eliminate inflammation. This is typically done through medication and diet.

5. Colorectal cancer

Symptoms

• Weight loss
• Change in appetite
• Change in bowel habits, often (but not always) with blood

Cancer of the colon (large intestine) or rectum is considered colorectal cancer. Colorectal cancer typically affects older adults (over age 50), but it can happen at any age. The cancers usually begin as small polyps, and over time, can become cancerous.

This is why colonoscopy screening is recommended: to find and remove these small polyps before they become cancerous. Colorectal cancer can cause a range of subtle and not so subtle symptoms, though usually there are some changes to your bowel habits and eating patterns.

Treatments include surgery, chemotherapy, and/or radiation.

Other possible causes of red stool

Dr. Rx

If you eat reddish tinted foods—beets, cranberries, and the like—you may not only notice reddish stools but darker urine as well. This is your body processing and expelling the byproducts of any food you consume—all normal! —Dr. Kumar

A number of conditions may also cause red stool, though these are either rare or red stool is not a main symptom.

• In babies, Meckel’s diverticulum can cause blood in the stool.
• Problems in the upper GI tract (esophagus, stomach, small intestine) can cause red blood, if the bleeding is brisk.

When to call the doctor

In general, if you experience it without a clear trigger (i.e., “I ate beets earlier today”), or if this is something that occurs more than once, you should call your doctor to discuss your symptoms.

Should I go to the ER for red stool?

Pro Tip

Red stool doesn’t necessarily indicate an emergency! —Dr. Kumar

You should go to the emergency department if you have any of these signs of a more serious problem.

• Intense abdominal pain
• High fever
• Stool that looks clumpy, like coffee grounds
• Bleeding that does not stop when you get up from the toilet
• Dizziness, lightheadedness
• Feeling faint
• If you are on blood thinners

Red stool treatments

Treatment is dependent on the cause. If you are having reddish stool based on your diet, no intervention is needed, and you do not need to stop eating those foods.

If you are bleeding, then the treatment is directed at the cause of the bleeding (i.e., hemorrhoid cream and treating constipation for hemorrhoids, or sitz baths and ensuring soft stools for anal fissures).

Shria Kumar, MD.

Therapeutic Endoscopy Fellow, MD Anderson Cancer Center, Houston, TX

Dr. Kumar is a gastroenterologist, who completed her fellowship at the Hospital of the University of Pennsylvania in Philadelphia. She received her undergraduate degrees in Religious Studies and Chemistry from New York University (2010) and graduated from the Albert Einstein College of Medicine (2014), where she was inducted into the Alpha Omega Alpha Honor Medical Society. She is completing her t…

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When to Worry About Blood in Stool

It can be unsettling to find signs of blood in your stool. But you shouldn’t immediately think the worst. True, blood in the stool may be caused by a variety of health conditions or diseases, including cancer, that could develop into serious health issues if left untreated. But the blood may also be a product of more benign conditions, such as hemorrhoids, which, while still unwanted, are often less serious than other conditions.

Still, if you notice blood in your stool after a bowel movement or blood when wiping, it’s a good idea to contact your doctor to find the cause, says Toufic Kachaamy, MD, Chief of Medicine at City of Hope Phoenix.

“Blood in the stool is always abnormal and needs to be investigated,” he says. “Never assume it’s benign or not significant until you’ve had a thorough investigation by your physician.”

In this article, we’ll explore the causes of rectal bleeding and bloody stools and what you should do about them, as well as explaining when to worry about blood in stool. Topics include:

• Conditions that may cause blood in stool
• Symptoms that may accompany rectal bleeding
• Rectal bleeding and cancer
• Why the color of the blood matters
• Rectal bleeding in young adults

If you’ve been diagnosed with cancer of the digestive system, including colorectal cancer, stomach cancer or esophageal cancer, and are interested in a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.

Conditions that may cause blood in stool

Your poop is made up of about 75 percent water, but it also contains an amalgam of undigested bits of food, mucus, dead cells and bacteria.

What shouldn’t be in your poop? Blood.

Many conditions, including cancer, that cause blood to appear in your stool may become serious if not addressed early. Some are related to auto-immune conditions, caused when an overactive immune system attacks healthy cells in the body. Others develop over time, perhaps due to diet or lifestyle, and may cause only minor pain or discomfort.

Conditions, other than cancer, that may cause blood in stool include:

Anal fissures: Small tears in the lining of the anus may be caused by constipation, difficult bowel movements or sexual activity.

Crohn’s disease or colitis: These auto-immune conditions may cause inflammation of the digestive system, leading to diarrhea and abdominal pain.

Diarrhea: Runny stools caused by illness, contaminated food or overindulgences may result in a sore or inflamed anus and blood streaks that appear on toilet paper after multiple bathroom trips.

Food poisoning: Tainted food may lead to infections that cause severe digestive distress.

Diverticulosis: Pouches in the lining of the colon, called diverticula, may become inflamed or infected.

Hemorrhoids: Swollen blood vessels in the rectum or on the anus may develop due to constipation or frequent sitting.

Ulcers: Open sores in the lining of the stomach or bowels are often caused by a bacterial infection.

Some of these conditions may heal or resolve themselves within a few days. But if they produce blood in the stool at any time, you should still tell your doctor, Dr. Kachaamy says.

“Sometimes blood in the stool can be caused by benign conditions such as hemorrhoids, a small fissure after constipation or an infection and can resolve on its own,” he says. “However, bleeding from cancer or inflammatory bowel disease can also be intermittent, and so any bleeding needs to be investigated. ”

Symptoms that may accompany rectal bleeding

In addition to bleeding, other symptoms may develop from some of these conditions. It’s important to tell your doctor about all the symptoms you’ve been experiencing and any family or personal history that may be related to your condition.

Other symptoms may include:

• Itching or burning in the anus
• Diarrhea or constipation
• Nausea or vomiting
• Cramps
• Bloating
• Pain
• Fever

Rectal bleeding and cancer

Blood in the stool often is a sign of bleeding in some area of the digestive tract, from the esophagus to the anus. And while bleeding may occur for a number of reasons, including the conditions listed above, it’s important to either rule out cancer or catch it when signs appear.

Cancer develops when mutated or damaged cells grow out of control. In many cases, the damage has affected the systems in the cells that regulate their growth and division. Cancers in the digestive system often develop in the soft lining of the esophagus, stomach, bowels or rectum and typically cause inflammation and bleeding.

Why the color of the blood matters

The color of the blood and the texture of the bloody stool may be influenced by many factors, especially what you’ve eaten. Beets can produce stool that turns the toilet water red or purple, while green, leafy vegetables rich in chlorophyll may produce darker stools.

If the bloody stool was caused by diseases such as cancer, the stool color may indicate where the bleeding is coming from in the digestive tract and may help doctors find its source.

For instance:

• Bright red blood in stool often means the blood is fresh and the bleeding is lower in the colon or rectum. This condition is called hematochezia.
• Dark red blood may mean the bleeding is higher in the colon or in the small intestine.
• Dark, tarry stool may mean the bleeding is in the stomach or the gastroesophageal junction—where the stomach meets the esophagus. This condition is called melena.

Polyps, which are small growths in the lining of the colon, may also grow and begin to bleed. Polyps may be benign at first, but they may develop into cancer. That’s why it’s important to talk to your doctor about when to get a colonoscopy, which is considered the gold standard for detecting colorectal cancer early. Colon polyps found during the procedure may be removed during the colonoscopy.

Rectal bleeding in young people

While cancer is most commonly diagnosed in older adults, young adults often develop conditions that may cause rectal bleeding. Irritable bowel diseases such as ulcerative colitis or Crohn’s disease often first begin affecting adults in their 20s or 30. These conditions may increase the risk of colorectal cancer later in life.

Also, new diagnoses of colorectal cancer are surging in young adults. The disease is now the leading cause of cancer deaths in people 20 to 45 years old. Dr. Kachaamy says young adults should not ignore blood in the stool, even if it goes away after a few days.

“While some conditions that cause bleeding resolve themselves quickly without treatment, other conditions like cancer and inflammatory disease will need treatment. Identifying them early offers you a stronger change for a better outcome,” he says. “Colorectal cancer—especially rectal cancer—is on the rise in young adults, and we currently do not screen average-risk adults below the age of 45. This means that to diagnose these diseases early, you need to be vigilant to early symptoms such as bleeding and not neglect these symptoms.”

If you’ve been diagnosed with cancer of the digestive system, including colorectal cancer, stomach cancer or esophageal cancer, and are interested in a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.

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