Seeing blood in your stool or on toilet paper can be frightening. While rectal bleeding is often caused by common and treatable conditions like hemorrhoids, it can sometimes signal a more serious issue.
At Colorectal Clinic of Tampa Bay, patients frequently ask: Is this something minor, or should I be worried? The answer depends on the pattern, associated symptoms, and your personal risk factors.
Understanding when rectal bleeding is serious can help you seek care at the right time — and avoid unnecessary delays.
What Is Rectal Bleeding?
Rectal bleeding refers to blood passing from the anus, often noticed:
On toilet paper
In the toilet bowl
Mixed with stool
As dark or tarry stools
The color and presentation of blood can provide important diagnostic clues.
Common (Less Serious) Causes of Rectal Bleeding
1. Hemorrhoids
Hemorrhoids are swollen veins in the rectum or anus and are one of the most common causes of bright red rectal bleeding.
Typical features:
Bright red blood on toilet paper
Blood after straining
Itching or discomfort
Hemorrhoids are very common, especially in adults over 45 (Riss et al., 2012).
2. Anal Fissures
An anal fissure is a small tear in the lining of the anus, often caused by constipation.
Symptoms include:
Sharp pain during bowel movements
Small amounts of bright red blood
Burning afterward
Fissures are usually benign but can become chronic without treatment.
When Rectal Bleeding May Be Serious
While many causes are harmless, rectal bleeding can also indicate more serious conditions.
1. Colorectal Cancer
Rectal bleeding is one of the most common presenting symptoms of colorectal cancer.
Studies show that rectal bleeding combined with a change in bowel habits significantly increases the likelihood of colorectal malignancy (Adelstein et al., 2011).
Additional warning signs include:
Unintentional weight loss
Persistent change in stool shape
Iron deficiency anemia
Ongoing abdominal pain
Colorectal cancer remains the third most common cancer in the United States (Siegel et al., 2023).
2. Colon Polyps
Polyps are abnormal growths in the colon that can bleed. While many polyps are benign, some may become cancerous over time.
Routine screening and early detection significantly reduce colorectal cancer mortality (USPSTF, 2021).
3. Inflammatory Bowel Disease (IBD)
Conditions like ulcerative colitis and Crohn’s disease can cause rectal bleeding due to inflammation of the intestinal lining.
IBD-related bleeding is often accompanied by:
Chronic diarrhea
Abdominal pain
Fatigue
Weight loss
4. Diverticular Bleeding
Diverticular disease can cause sudden, painless rectal bleeding. It is more common in older adults and may sometimes require urgent medical care (Strate & Gralnek, 2016).
Warning Signs That Rectal Bleeding Is Serious
You should seek prompt evaluation if you experience:
Large amounts of blood
Dark, tarry stools
Dizziness or weakness
Bleeding that persists more than a few days
Bleeding with unexplained weight loss
Family history of colorectal cancer
Age also matters. Adults over 45 should not ignore rectal bleeding, even if hemorrhoids are suspected (USPSTF, 2021).
Why You Should Not Assume It’s “Just Hemorrhoids”
Research shows that patients sometimes attribute rectal bleeding to hemorrhoids and delay evaluation, which can postpone cancer diagnosis (Adelstein et al., 2011).
Even if hemorrhoids are present, they do not rule out other causes higher in the colon.
Proper evaluation may include:
Physical examination
Anoscopy
Colonoscopy
Imaging if needed
At Colorectal Clinic of Tampa Bay, specialists perform thorough evaluations to determine the exact cause and rule out serious conditions.
When to See a Colorectal Specialist
You should schedule an appointment if:
Bleeding is recurrent
You are over 45
You have a family history of colorectal cancer
You experience changes in bowel habits
Symptoms persist despite over-the-counter treatment
Early evaluation provides reassurance — or early detection when it matters most.
How Colorectal Clinic of Tampa Bay Can Help
At Colorectal Clinic of Tampa Bay, our board-certified specialists diagnose and treat a full range of colorectal conditions, including:
Hemorrhoids
Anal fissures
Colon polyps
Inflammatory bowel disease
Colorectal cancer
We prioritize timely evaluation, advanced diagnostics, and patient-centered care to ensure peace of mind and effective treatment.
Rectal bleeding may be common — but it should never be ignored.
Rectal bleeding is often caused by benign conditions like hemorrhoids or fissures. However, it can also be an early sign of colorectal cancer, polyps, inflammatory bowel disease, or diverticular disease (Adelstein et al., 2011; Siegel et al., 2023). Persistent, recurrent, or unexplained bleeding warrants medical evaluation.
If you’re unsure whether your symptoms are serious, expert assessment at Colorectal Clinic of Tampa Bay can provide clarity and peace of mind.
Works Cited
Adelstein, B. A., Macaskill, P., Chan, S. F., Katelaris, P. H., & Irwig, L. (2011). Most bowel cancer symptoms do not indicate colorectal cancer and polyps: A systematic review. BMC Gastroenterology, 11, 65. https://doi.org/10.1186/1471-230X-11-65
Riss, S., Weiser, F. A., Schwameis, K., Riss, T., Mittlböck, M., & Stift, A. (2012). The prevalence of hemorrhoids in adults. International Journal of Colorectal Disease, 27(2), 215–220. https://doi.org/10.1007/s00384-011-1316-3
Siegel, R. L., Miller, K. D., Wagle, N. S., & Jemal, A. (2023). Cancer statistics, 2023. CA: A Cancer Journal for Clinicians, 73(1), 17–48. https://doi.org/10.3322/caac.21763
Strate, L. L., & Gralnek, I. M. (2016). Management of patients with acute lower gastrointestinal bleeding. American Journal of Gastroenterology, 111(5), 755–770. https://doi.org/10.1038/ajg.2016.41
U.S. Preventive Services Task Force (USPSTF). (2021). Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA, 325(19), 1965–1977. https://doi.org/10.1001/jama.2021.6238