Bleeding from the bottom (rectal bleeding)

A small amount of bleeding from the bottom that happens once is not usually a serious problem. But it's a good idea to check with your GP.

Check if you're bleeding from the bottom

You may 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, smelly poo (this can be blood mixed in poo)

A small amount of bleeding that happens once can often go away on its own without treatment.

Bleeding from the bottom is sometimes a sign of bowel cancer. It's important to contact a GP if you have any symptoms of bowel cancer. Finding cancer early may mean it's easier to treat.

Non-urgent advice: Contact your GP if:

your child has blood in their poo
you have blood in your poo for 3 weeks
your poo is softer, thinner or longer than normal for 3 weeks
you have a lot of pain around the bottom
you have a pain or lump in your tummy
you are more tired than usual
you lost weight for no reason
your poo is black or dark red
you have bloody diarrhoea

Urgent advice: Call 112 or 999 or go to your nearest emergency department if:

you're bleeding non-stop
there's a lot of blood - for example, you see large blood clots in the toilet

What happens at your GP appointment

Your GP will check what's causing your symptoms.

They may:

check your bottom (rectum) with a gloved finger
ask for a sample of poo for testing
refer you to a specialist for tests

Causes of bleeding from the bottom

If you have other symptoms, this may help you find the cause of your bleeding.

Do not diagnose yourself. Contact your GP if you're worried.

Bright red blood on toilet paper, streaks on poo, pink toilet water

Causes of bright red blood from your bottom can include:

piles (haemorrhoids) - if you have pain when pooing, an itchy bottom or lumps
a small tear in your anus (anal fissure) - if you have pain when pooing, often after constipation
a sexually transmitted infection (STI) such as genital warts - if you have pain or itching with or without lumps
a side effect of blood-thinning medicine such as warfarin or aspirin
broken blood vessels in the gut (angiodysplasia)
rubbing too hard with toilet paper

Anal sex can cause bleeding from the bottom. This is common and not usually sign of something more serious.

If you have painful bleeding after anal sex or symptoms of an STI, contact your GP.

Blood in your poo or blood with slime

Poo can look like it's mixed with blood if you've eaten a lot of red or purple foods. For example, tomatoes or beetroot.

Sometimes it is a sign of something else. Your GP can check if you're worried.

Causes of blood in poo or blood with slime can include:

bleeding in the anus, bowel or lower gut - this can be from an injury or another problem
an anal fistula - if you have yellow slime when you poo, an irritated anus and constant bottom pain
a tummy bug (gastroenteritis) - if you have diarrhoea with clear slime, nausea and vomiting
an inflammatory bowel disease (IBD) such as Crohn's disease - if you have diarrhoea, tummy cramps, pain and bloating
bowel polyps - if you have slime with your poo and a change in your pooing habits, such as looser poo, diarrhoea or constipation
bowel cancer - if changes in your pooing habits do not go away or you have anaemia (low red cells in your blood)

Very dark or black blood or poo

Poo can look very dark or black if you:

take iron tablets
eat a lot of dark foods such as liquorice and blueberries

But it's sometimes a sign of something else. Your GP can do a test if you're worried.

Causes of dark blood or black poo can include:

bleeding in the stomach or gut from an injury
stomach ulcer, diverticular disease and diverticulitis - you may also have tummy pain or cramps
blood-thinning medicines such as aspirin or warfarin
broken blood vessels in the gut (angiodysplasia)

Content supplied by the NHS and adapted for Ireland by the HSE

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 4 December 2025
Next review due: 4 December 2028