Should You Be Worried About A Large Amount Of Bright Red Blood In Toilet?

Finding a large amount of bright red blood in the toilet can be alarming. While it's natural to worry about the potential causes of this symptom, there are many possible explanations, some of which may not be serious. It should also be noted that only a couple of drops of blood can turn the toilet bowl red, so in most cases, the amount of blood is hard to judge.

However, it's important to seek medical attention even if you think the cause of the bleeding is minor. Your doctor can perform a physical examination, order tests, and make a diagnosis to determine the cause and recommend treatment.

This article explores the possible causes and treatment options for a large amount of bright red blood in the toilet. With this, you can easily take the necessary steps to address your symptoms and maintain your overall health.

Meaning of the color of blood in stool

The color of the blood in the stool can provide clues about the location and severity of the bleeding. Some of the most prevalent stool colors are:

Bright red blood

Bright red blood in the toilet usually indicates that the bleeding is coming from the lower part of the digestive tract, such as the anus or rectum. This type of bleeding is usually more minor and easier to treat than bleeding from other parts of the digestive tract.

Maroon red blood

Maroon red or dark red blood in the stool, sometimes intermixed with bright red blood, means the bleeding comes from higher up in the digestive tract, such as a proximal colonic or maybe a small intestinal source.

Dark red blood (melena)

Dark and tar-like stool (melena) suggests that the bleeding is coming from your upper GI tract or a slow proximal colonic bleeding. 

Possible causes of bright red blood in stool

There are many possible causes of bright red blood in the toilet, ranging from minor to severe. Of note, benign etiologies are the most common and account for over 90% of complaints of minimal bright red blood per rectum in adults. Some common causes include:¹

Hemorrhoids

Also known as piles, hemorrhoids are swollen veins in the anal canal. They can cause itching, pain, and bright red blood in the toilet, particularly after a bowel movement.

Some of the risk factors for these swollen veins include:

• Constipation

• Pregnancy

• Age between 45–65

Hemorrhoids are usually not severe and can be easily treated with over-the-counter medications, such as creams and ointments.

Anal fissures

Anal fissures are small tears or cuts in the tissue lining the anus. They are associated with hard stools, pregnancy, and opioids.²

Besides bright red blood in the toilet, anal fissures also cause pain and discomfort during bowel movements. About 60% of these tears heal on their own in about 6–8 weeks, and 20% will heal with topical medication.

Proctitis

Proctitis is the inflammation of the rectum, commonly seen in the context of ulcerative colitis, an inflammatory bowel disease. Patients in this context typically present insidiously with rectal bleeding and mild diarrhea.

Diverticulosis

Diverticulosis is a condition where small pockets or sacs in the walls of the colon become infected or inflamed.

Diverticulitis can cause:

• Abdominal pain

• Nausea

• Fever

You can treat mild diverticulitis with antibiotics and a change in diet. Surgery may be necessary in cases of recurring or severe diverticulitis. However, diverticulosis is typically an incidental finding during workup of bright red blood per rectum, as diverticular bleeding is more acute and voluminous. 

Colon polyps

Colon polyps are small growths that can develop in the colon or rectum and are typically asymptomatic. While most polyps are harmless, some can develop into cancer if left untreated. 

These small growths are more common among people who:

• Are 50 years and above

• Are overweight

• Have a family or personal history of colon polyps

Rectal ulcers 

Rectal ulcers are open sores that can occur in the lining of the rectum. Solitary rectal ulcer syndrome typically presents with rectal bleeding, straining during defecation, and tenesmus, although it is uncommon. 

How can you diagnose the cause of a large amount of blood in the stool?

As previously stated, you should contact your doctor as soon as possible whenever you notice a large amount of bright red blood in the toilet. The doctor will ask about your symptoms and medical history and may perform a physical examination to determine the cause of the bleeding.

Your healthcare provider may also recommend one or more of the following diagnostic tests:

Fecal occult blood test

A fecal occult blood test involves collecting a small sample of your stool and sending it to a laboratory for blood testing. It's a non-invasive method that helps identify the presence of bleeding in the digestive tract.

Colonoscopy

A colonoscopy is a procedure that involves inserting a flexible tube with a camera into the colon through the rectum and anus. This allows for a visual examination of the colon's interior and the identification of any abnormalities or areas of bleeding.

Sigmoidoscopy

A sigmoidoscopy is similar to a colonoscopy, but it only examines the lower part of the colon. It is often used to diagnose and treat problems in this area (the sigmoid) of the digestive tract, making it less invasive than colonoscopy.

Esophagogastroduodenoscopy

In this procedure, a thin, flexible tube with a camera is inserted into the mouth to examine the inside of the digestive tract. It usually focuses on problems relating to the esophagus, stomach, and small intestine.

CT scan

To discover the cause of blood in your stool, the doctor can also request a CT scan. This is an imaging test that uses x-rays and a computer to create detailed images of the inside of the body. It can identify abnormalities in the digestive tract, such as tumors or areas of bleeding.

How to treat bright red blood in stool

The treatment for bright red blood in the toilet will depend on the underlying cause of the bleeding. Here is how you can deal with such a condition:

Medications

Depending on the cause of the bleeding, your healthcare provider may prescribe medications to stop the bleeding and reduce inflammation. This may include antibiotics for infections or corticosteroids for inflammation.

Surgery

Surgery may be necessary to remove colon polyps, repair tears or abnormalities in the digestive tract, or treat colorectal cancer.

Lifestyle changes

Your doctor may also ask you to make specific lifestyle changes to reduce the risk of bleeding or prevent it from recurring. Some of these lifestyle changes may include:

• Eating a high-fiber diet to prevent constipation³

• Avoiding straining during bowel movements

• Avoiding heavy alcohol use

Non-surgical procedures

Doctors use these treatment options in patients with less severe bleeding. It stops the bleeding and repairs any abnormalities in the digestive tract.

Here are a few non-surgical procedures:

• Rubber band ligation to treat hemorrhoids

• Botulinum toxin injection for anal fissures

Remember to follow your healthcare provider's recommendations and take all prescribed medications as directed to ensure the most effective treatment.

The lowdown

It's important to be aware of changes in your stool color as well as any possible blood in the stool. Bright red blood in the stool can signify several potential health issues, some of which may be more serious than others.

If you notice a large amount of bright red blood in the toilet, discuss it with a healthcare professional as soon as possible. They will assess your symptoms and determine the cause of the bleeding.

Frequently asked questions

Can you bleed a lot with hemorrhoids?

Yes, it is possible to bleed a lot from hemorrhoids. That's because hemorrhoids are enlarged veins. 

What does cancerous blood in stool look like?

Bright red blood in the toilet can be a sign of colon cancer. However, blood in the stool can also be a sign of other conditions, such as hemorrhoids or anal fissures.

Should I go to the ER for bright red blood in the stool?

If you are experiencing bright red blood in your stool, it is essential to seek medical attention as soon as possible. The healthcare provider will give you advice on the best cause of action. 

However, over 90% of bright red blood per rectum complaints are due to benign causes. It should also be noted that only a couple of drops of blood can turn the toilet bowl red, so in most cases, the amount of blood is hard to judge.

Why am I pooping a lot of bright red blood?

The presence of bright red blood in the stool can be a sign of many conditions, including hemorrhoids, anal fissures, and colorectal cancer.