Bleeding from the bottom (rectal bleeding)

A small amount of one-off bleeding from the bottom 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 might 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 one-off bleeding can often go away on its own without needing treatment.

Contact your GP if:

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

Your GP will check what's causing your symptoms.

They might:

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

Immediate action required: Call 999 or 112 for an ambulance or go to your nearest emergency department (ED) if:

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

Bowel cancer risk

Bleeding from the bottom is sometimes a sign of bowel cancer.

This is easier to treat if it's found early, so it's important to get it checked.

Bowel cancer screening

Symptoms and causes of bleeding from the bottom

If you have other symptoms, this might give you an idea of the cause.

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

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

Symptoms Possible causes
Symptoms Bright red blood and pain when pooing, itchy bottom, lumps Possible causes piles (haemorrhoids)
Symptoms Bright red blood and pain when pooing – often after constipation Possible causes a small tear in your anus (anal fissure)
Symptoms Bleeding with or without lumps, itching or pain Possible causes sexually transmitted infections (STIs) like genital warts, damage from anal sex
Symptoms Bright red blood without pain Possible causes side effect of blood-thinning medicine like warfarin or aspirin, broken blood vessels in the gut (angiodysplasia)

Blood in 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 like tomatoes and beetroot.

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

Symptoms Possible causes
Symptoms Blood and yellow slime when pooing, irritated anus, non stop bottom pain Possible causes anal fistula
Symptoms Bloody diarrhoea with clear slime, feeling and being sick Possible causes tummy bug (gastroenteritis)
Symptoms Bloody diarrhoea, tummy cramps and pain, feeling bloated Possible causes an inflammatory bowel disease (IBD) like ulcerative colitis or Crohn's disease
Symptoms Blood in poo Possible causes bleeding in the anus, bowel or lower gut from injury or another problem
Symptoms Blood in poo, change in pooing habits (like looser poo, diarrhoea or constipation), slime with poo Possible causes bowel polyps, early signs of bowel cancer

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 like liquorice and blueberries

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

Symptoms Possible causes
Symptoms Dark or black poo Possible causes bleeding in the stomach or gut – this can be from injury or a side effect of blood-thinning medicine like warfarin or aspirin
Symptoms Dark blood or poo with tummy pain or cramps Possible causes stomach ulcer, diverticular disease and diverticulitis
Symptoms Dark blood without pain Possible causes blood-thinning medicine like warfarin or aspirin, angiodysplasia (broken blood vessels in the gut)


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

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

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