Noticing blood when you wipe, sometimes called rectal bleeding, is a common symptom with several possible causes, ranging from haemorrhoids to conditions that need closer investigation. It is understandable to want to assume the least serious explanation, but a proper assessment is the only way to know for certain, and most causes turn out to be very treatable.
What causes blood when wiping?
Haemorrhoids
The most common cause, typically bright red blood on the paper or in the pan
Anal fissure
Often bleeding with sharp pain during a bowel movement
Diverticular disease
Can cause sudden, sometimes heavier bleeding
Bowel polyps
Usually cause no other symptoms besides bleeding
Inflammatory bowel disease
Bleeding often alongside a change in bowel habit
Bowel cancer
Less common, but an important cause to rule out, particularly with other symptoms
When to seek assessment promptly
- Bleeding that is new, especially if you are over 50
- Bleeding alongside a change in bowel habit
- Bleeding with abdominal pain, weight loss, or unexplained tiredness
- Bleeding that persists despite treating suspected haemorrhoids
- A family history of bowel cancer or polyps
How it is investigated
Assessment usually starts with a straightforward examination in clinic, which identifies the cause in many cases without further tests. If needed, a flexible sigmoidoscopy or full colonoscopy can be arranged promptly to get a clear answer, with any findings, such as haemorrhoids, a fissure, or polyps, treated or managed directly. Knowing the cause is reassuring in itself, and it means any minor cause can be dealt with properly rather than left to keep recurring.
Heavy or ongoing bleeding, bleeding with dizziness or fainting, or bleeding alongside severe abdominal pain needs urgent medical attention. Do not wait for a routine appointment.