At London Doctors Clinic, we regularly see patients wishing to discuss their concerns regarding any changes to their bowel habits. One symptom of particular concern is finding blood in the stool, which is always worth getting checked out by a doctor. Some people may find this problem a little embarrassing, but this is quite a common problem and something your our private doctors are used to dealing with and around 10% of UK adults get rectal bleeding (bleeding from the back passage) every year.


Noticed Blood In Your Stool?

The first questions your doctor will ask will likely be regarding the colour, nature and amount of blood you noticed. These questions are important in helping your doctor figure out where the blood might be coming from. The doctor will then ask you some more specific questions about the symptoms you are experiencing, such as whether you noticed the blood in the pan, or while wiping. As squeamish as you may be about discussing such a subject, the more details you can provide, the better!

Bright-red blood suggests that the blood is coming from near your anus. This could suggest you have haemorrhoids (piles) or a small tear around the anus (an anal fissure).

If the blood is darker or sticky, it is likely that the bleeding is coming up from higher up in your gastrointestinal system. You may also notice that your stools have become black or plum coloured, which is known as melaena. If you have black or plum-coloured stool, this may be an emergency – you must get medical help immediately. 


What Will The GP Do?

Your GP will most likely need to examine you to determine what is causing your rectal bleeding, by means of a rectal examination. This involves placing a gloved, lubricated finger inside the bottom (rectum). GPs often perform this examination to investigate various other conditions, so you should be reassured that it is quick and painless.

This can help check for certain causes of rectal bleeding (such as piles) and will help your GP determine how to best organise your ongoing care and treatment. You may need to be referred to the hospital for further tests with a specialist.


What Can Cause Blood in The Stool?

There are lots of different conditions that can cause blood in the stool. Below are some short summaries of some of these, but your GP is the best person to diagnose what is going on.

  • Piles
    • These are swollen blood vessels around the anus, which can cause itching or can bleed when you have a bowel movement. With piles, you might notice bright red blood on the toilet paper.
  • Anal fissure
    • This is a tear in the skin of the anus which can be really very painful. Again you will usually notice bright red blood. You might also notice that you feel like you need to pass stools more frequently, even when you have emptied your bowel.
  • Anal fistula
    • This is a channel which can develop between the last part of the bowel (the anal canal/back passage) and the skin around the anus. These are usually painful and can bleed. 
  • Gastroenteritis
    • A tummy bug (whether viral or bacterial) can cause diarrhoea which also contains blood and mucus, together with vomiting and cramps.
  • Diverticula
    • These are small bulges in the large bowel which have blood vessels in them, which are weak and can burst. This can lead to large amounts of painless blood in the stool all of a sudden. These diverticula can also sometimes become inflamed and problematic, in the condition diverticulitis.
  • Bowel cancer
    • This is often the thing people are most worried about when they have rectal bleeding. Blood in the stool can be the only symptom of bowel cancer but that’s not to say you definitely have it.



There are many different conditions that cause blood in the stool. If you're experiencing this symptom, always seek medical advice


Rarer Causes of Rectal Bleeding

Aside from the above, more common causes for this concerning symptom, there are a few other causes of blood in the stool, including:

  • Certain medication (especially blood thinners, such as Warfarin)
  • Inflammatory bowel disease
  • Bowel polyps (these are small growths on the inside of the colon or rectum that are usually benign)
  • Sexually transmitted infections (if you have had any sexual intercourse involving the anal area)


Blood In The Stool: When To Be Concerned

After visiting your GP, they will usually provide you with an urgent referral to a specialist (within 2 weeks) if you fulfil any of the below criteria:

  • You’re 40 years old or older, and have had loose or more frequent stools over the past six weeks
  • You’re 60 years old or over and you’ve had bleeding for over six weeks
  • Your GP has found something abnormal when they examined you
  • You are found to be anaemic
  • A family history of bowel cancer
  • You have ulcerative colitis

This referral is deemed urgent, as there is a risk of bowel cancer that needs to be either investigated or ruled out as soon as possible. Should you not meet the above criteria, your doctor may still recommend a routine specialist referral to further investigate the cause of your symptoms. 



After an examination, your GP might refer you to a specialise, especially you are found to be anaemic 


The take-home message of this article is that whatever the cause of the rectal bleeding, it is always worth getting it fully investigated. Please don't try and self-diagnose, as although there are several harmless causes of rectal bleeding, there is also a risk of serious conditions such as bowel cancer, than only a doctor can safely rule out. Book in for a quick, convenient, same day doctor appointment at any of our nine London clinics, for the peace of mind you may require.