Rectal Bleeding – Is It Colon Cancer?

Rectal Bleeding

So you probably came across this article quite hesitantly and with a ton of anxiety.

You went to the bathroom, saw blood, nearly fainted, and called in for backup… The all-knowing Google!

First off, you are not alone.

Having blood on your toilet paper, in your toilet, or on/mixed with your stool is actually quite common.

Read on to see what it could potentially be and what to expect from your doctor’s visit.

Why Am I Bleeding After I Have A Bowel Movement

Good question, my friend!

Fortunately, you don’t have to immediately think the worst.

There are a lot of different reasons that you can be passing blood with your poop.

Your doctor will refer to this as rectal bleeding.

So what are the potential culprits of your panic?

  1. Hemorrhoids
  2. Fissures
  3. Abscess/Fistula-in-ano
  4. Proctitis
  5. Diverticulosis
  6. Polyps – Rectal Cancer

While all of these are concerning, some of them are much easier to treat. The ones towards the bottom of the list are much more concerning.

Let’s talk a little bit about each one so that you can better understand what might be going on.


rectal bleeding tissue paper

A lot of times when people see blood in the toilet or on their toilet paper they will just chalk it up to being hemorrhoids.

No big deal. I’m fine!

This definitely is a common diagnosis.

Certain situations — like pregnancy — can increase your chances of getting hemorrhoids.

Hemorrhoids are typically caused by either excessive force needed to push out your feces, longer amounts of time to successfully make a bowel movement or increased frequency of bathroom trips.

There are two types of hemorrhoids: external and internal.

External hemorrhoids are typically painful and cause you to see blood when you wipe.

Internal hemorrhoids will cause slightly more bleeding and less pain.

Internal hemorrhoids can be classified into 4 different groups depending on severity. 1 causing the least concern and 4 being the most painful and problematic.

Doctors typically recommend using TONE as your goal guidelines to get rid of hemorrhoids.

T – Three minutes to make a bowel movement

O – defecating Once per day

N – Not straining during your bathroom trips

E – eating Enough fiber


Fissures usually show as blood on toilet paper or sometimes as drops of blood in the toilet.

Fissures are another cause of rectal bleeding that can be grouped into two categories: acute (primary) and chronic (secondary).

Acute fissures are usually found along the front or back walls of the anal canal.

These types of fissures are usually extremely painful.

You can treat acute fissures quite easily by increasing your fiber intake, using ointments, and taking sitz baths.

Chronic fissures are typically found along the sides of the anal canal. Chronic fissures are a good indicator of a coexisting disease causing the bleeding and fissures.

Some diseases that tend to cause fissures include Crohn’s Disease, syphilis, HIV, anal cancer or leukemia.

Anal cancers will start out looking like fissures that don’t cause much pain.

However, anal fissures that do not seem to heal over time have a higher chance of being cancerous.


With an abscess or fistula-in-ano, typically rectal bleeding won’t be an issue, however, rectal bleeding is usually what sends patients into the doctor’s office when they receive a diagnosis of an abscess.

Although they are typically grouped together, there are differences between anal abscesses and ano fistulas.

Anal abscesses are pus-filled cavities or infected cavities that happen close to the anus or rectum.

A fistula-in-ano is a little tunnel that goes from the anal canal out to the outside of the skin.

They can be a result of an abscess or can occur on their own. 50% of people get fistulas from abscesses.

A study was done on 64 people to see if draining of perianal abscesses created a higher chance of getting anal fistulas.

31% of the patients ended up with fistulas after perianal abscess drainage and it seemed to be a higher rate for those under 40 years old and non-diabetics.


Proctitis is associated with bright red and sometimes mucousy rectal bleeding.

Proctitis usually causes you to have frequent, very small bowel movements. Post-bowel movement can be accompanied by mild cramping in the abdomen.


Diverticulosis will have the most amount of blood when dealing with rectal bleeding.

Usually, the amount of blood associated with diverticulosis sends the patients right to the emergency room.

Initially the blood will look to be mixed with the bowel movement, however, after several times in the bathroom, it will look more like a passing of blood clots and less like stool.

Diverticulosis is another condition that will cause intense cramping in your lower abdomen.

Polyps/Colorectal Cancer

Colorectal Cancer

Okay! You have arrived at the conclusion of our initial question.

Obviously, the answer is no, not all rectal bleeding is a sign of cancer.

However, even though it isn’t always the case, you aren’t totally in the clear either.

Rectal bleeding is a sign of cancer in the colon or rectum. It isn’t easily diagnosed based on the type of bleeding, though.

While some studies have found that blood mixed with stool can be a sign of colorectal cancer, there are conflicting outcomes from other studies saying different.

Polyps are not always cancerous.

When a polyp is found on any test there are different determining factors that doctors will take into account before proceeding with other tests.

Doctors will check the size, placement, and other qualities of the polyp.

Larger, irregularly shaped, or immovable polyps tend to show more signs of carcinoma.

Rectal bleeding is usually a sign of a much more serious and progressed form of rectal cancer (Stage III or IV).

The likelihood of rectal bleeding being from cancer is very low.

Of the 19% of patients that see their general practitioner for rectal bleeding about 97% will NOT have colorectal cancer.

Who Has a Higher Risk for Colorectal Cancer?

So even though 97% is a big number there is still that 3% of people with rectal bleeding that end up with cancer.

Some people are more at risk than others and should take rectal bleeding a little more seriously.

If you are grouped into any of the following, you should definitely talk with your doctor about your rectal bleeding:

What Will a Doctor’s Appointment be Like for Rectal Bleeding?

This is definitely something we all feel uncomfortable bringing up to anyone, even our doctors.

Remember, the earlier you get your symptoms addressed the better chance you have of surviving a dangerous diagnosis.

Also, keep in mind that this is your doctor’s job.

This is what they went to school for, they expect to talk about these uncomfortable subjects with you!

Some different tests your doctor might do will include:

  • Personal history intake (make sure to let them know of all procedures you’ve had done in the past even if you don’t think they’re relevant)
  • Physical examination of your anus
  • Digital testing– feeling inside of your anus with their finger to check for polyps, hemorrhoids, and other physical abnormalities
  • Anoscopes– tools that allow doctors to see into the first section of your anal canal
  • Sigmoidoscopes (rigid or flexible) – camera used to view and biopsy the lower part of the colon
  • Colonoscopes– this is one of the most commonly heard of tests used. They are used to check the entire colon for masses and other issues.

You may need to fast or eat a diet before certain tests.

This is to ensure that your doctor can see all parts of your colon clearly. Your doctor will instruct you on what you need to do before your test.

Try to remain calm throughout the entire process.

It is a scary thing when you see blood, but your doctor is always there to help you.

Hopefully, you feel a little more comfortable about addressing this with your doctor.

The only way to know the cause is to bring up your rectal bleeding and get tested.

Have questions or comments? Drop them below!

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