Persistent bleeding from the back passage (anal or rectal bleeding) is something that you should always see a doctor about, even if you are convinced it is piles (haemorrhoids) or an anal fissure, as the blood can come from anywhere in your bowels. The reason you should be checked is because rectal bleeding or blood in your poo can be a symptom of serious bowel disease, for example colon or rectal cancer or inflammatory bowel disease. If you are worried about being examined in that area, look at the section on seeing your doctor about an anal problem.

In general, if the bleeding is bright red and you have anal pain, especially when you pass a stool, it is likely to be a less serious condition such as an anal fissure or piles – but your doctor needs to make sure.

If the bleeding is dark red, or in clots, or mixed with a lot of slime, or mixed in with the poo, it could be a more serious condition (such as colitis, diverticular disease or cancer of the rectum or colon) that needs prompt treatment. Other symptoms that might be serious are a persistent change in the frequency and/or hardness of the poo.

What Do You Know about Bowel Cancer?

An evaluation of a bowel cancer awareness pilot in the South West and East of England in 2011 showed that awareness that blood in poo can indicate bowel cancer rose from 19% to 38%, particularly in those aged under 75.

Home Testing for Blood in Poo

The UK Government sends home-testing kits for blood in the poo every 2 years to people aged 60–74 years in England, Wales and Northern Ireland and to those aged 50–74 in Scotland. People over 75 can request a home screening kit every 2 years. This is part of the NHS Bowel Screening Programme. The aim is to detect bowel cancer early. So if you receive a kit, use it and return according to the instructions.
Bowel scope screening testing is being rolled out across England, Wales and Northern Ireland for those aged 55. This involves a small flexible tube (sigmoidoscope) being inserted to look for polyps and pre-cancerous growths.


First published on:
Reviewed and edited by: Dr Kevin Barrett
Last updated: October 2020

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