Rectal bleeding in men: what you should know

Bright red blood on toilet paper or on the outside of the stool may arise near the anus, particularly with pain during a hard bowel movement. It can also come from farther inside the lower bowel. Maroon blood, black tarry stool, or blood mixed through the stool needs medical assessment because it may reflect bleeding higher in the digestive tract or a bowel condition.

Possible causes include haemorrhoids, anal fissures, diverticular disease, gastroenteritis, and inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. Polyps and bowel cancers can bleed too. A symptom does not identify its cause on its own: a bowel lump or bleeding is not proof of cancer, but persistent or unexplained bleeding should be checked.

Tell a clinician whether the bleeding is new, recurrent, or increasing, and whether you have constipation, diarrhoea, abdominal pain, fever, weight change, tiredness, or a change in bowel habit. They may examine the anus and rectum and decide whether blood tests or bowel investigations are needed.

Arrange a medical appointment for any unexplained rectal bleeding, even if it stops, and mention medicines that can increase bleeding, such as anticoagulants or antiplatelet drugs. Do not stop a prescribed medicine without medical advice.

Record the colour and amount of blood, when it appeared, whether it was on the paper or mixed with stool, and any pain or bowel changes. Avoid straining and keep stools soft with fluids and fibre if these are suitable for you. A clinician can advise on treatment after identifying the source; some bowel polyps can be treated with polyp removal.

Seek urgent medical help if bleeding is heavy or continuous, you pass clots, feel faint or confused, become unusually weak or short of breath, or have severe abdominal or rectal pain. Black, tarry stool or dark red blood also warrants urgent assessment, especially with dizziness or vomiting.

A fever with bloody diarrhoea, repeated bleeding, or bleeding with a new change in bowel habit should be assessed promptly. Emergency services are appropriate if you feel you may collapse or cannot stay awake.

Ask what the colour and pattern of bleeding suggest, whether your medicines or bowel habits could contribute, and which examination or tests are appropriate. You can also ask what symptoms should prompt urgent help and when to return if the bleeding recurs.