Why Is My Poop Red? Causes and Diagnosis

Having red stool (poop) is not always a reason to worry because it does not always mean you have blood in your stool (hematochezia). Sometimes, your poop is red because you’ve had red or orange foods. However, if you can’t trace the color back to something you’ve eaten or if you’ve had more than one red stool, don’t ignore it. If it is blood, you need to see a healthcare provider. 

In general, the brighter the blood, the more likely that it’s coming from the lower gastrointestinal tract, such as the colon (large intestine). A darker color may mean the blood is from higher up (such as in the esophagus, stomach, or small intestine).

This article covers the reasons why your poop might be read including when you should see a provider for red-colored stool. 

Symptoms of Hematochezia

Other symptoms along with red poop depend on what is causing it. If your stool is red because of some food that you recently ate, you may just notice the color with no other symptoms.

If your stool is red because of blood from minor health conditions like hemorrhoids and anal fissures, you may have rectal pain, especially during or after going to the bathroom. You may also notice anal lumps, swelling, and constipation. In these cases, you may not see blood in the stool but on the toilet paper after you wipe.

If a more serious condition like colon cancer is the cause of red poop, the other symptoms can include rectal pain, abdominal pain, nausea, vomiting, unexplained weight loss, and anemia.

Causes of Hematochezia

Several different types of food with natural or artificial coloring may cause the stool to be red. This can often look like blood, but it isn’t. Check food labels because the food might not appear red but may still have red food coloring in it.

Red Foods

Some of the foods that can cause red poop include:

• Red gelatin, popsicles, Gatorade, or Kool-Aid
• Tomato juice or soup
• Large amounts of beets
• Anything colored with red food coloring (red #40)

The most common causes of actually having blood in your stool (hematochezia) include:

• Hemorrhoids
• Anal fissures
• Diverticular bleeding
• Inflammatory bowel disease (IBD)

Hemorrhoids

Hemorrhoids are a common cause of bright red blood in the stool or on toilet paper. Hemorrhoids are a common cause of bright red blood in the stool or on the toilet paper when you wipe. A hemorrhoid is a form of varicose vein. 

Hemorrhoids can often be managed by increasing fluids and fiber in your diet (either with foods or a fiber supplement). This can keep stool soft and ease constipation, which allows fissures or hemorrhoids to heal.

Anal Injuries or Conditions

There are some conditions or injuries that can affect the anus and may lead to bleeding. 

• An anal fissure is a tear or ulcer (sore) in the lining of the anal canal (the last part of the rectum before the anus). Anybody can get an anal fissure but they’re more common in middle-aged people and infants. They can be caused by constipation with straining and childbirth.
• Proctitis is inflammation of the lining of the rectum. It can be an acute or long-term (chronic) health problem. Some people with inflammatory bowel disease get proctitis, and it can also be caused by radiation treatment. 
• Anorectal abscess is a pocket of pus around the anus. It can be caused by things like infections, trauma, blocked glands, and sexually transmitted infections (STIs).

Diverticular Bleeding

A diverticulum is a small pouch in the colon that bulges out of a weak spot in the colon wall. Having diverticula in the colon is called diverticulosis. It’s not understood what causes the condition, but researchers think that age and genetics play a role.

Diverticulosis affects about 10% percent of Americans over the age of 40 and about 50% of Americans over the age of 60. Although it’s not common, diverticulosis can cause bloody stools. The bleeding does not usually need treatment unless it’s continuous or severe.

Inflammatory Bowel Disease

Ulcerative colitis and Crohn’s disease are incurable chronic diseases of the gastrointestinal tract. Together, they are known as inflammatory bowel disease (IBD). IBD has active periods (“flares”) that can cause hematochezia.

It’s not known what causes IBD, but it’s thought to be linked to an overactive and problematic immune system response. Genetics also appear to play a role in these conditions.

If you have bloody stools caused by IBD, a healthcare provider may recommend diet changes and anti-inflammatory medications to control inflammation. In rare cases, surgery is needed to repair or remove parts of the gastrointestinal tract and relieve IBD symptoms.

Colon Polyps or Cancer

A less common cause of blood in the stool is a colon polyp. Sometimes, a polyp can bleed and lead to blood in the stool. Although rare, colon cancers can develop from polyps.

If a colon polyp or cancer is the cause of hematochezia, the growth will need to be removed during a colonoscopy or other surgery.

When to See a Healthcare Provider

If you notice blood in your stool, on toilet tissue, or in your clothing, see your healthcare provider as soon as you can. Even though most cases of hematochezia are not caused by serious conditions, you won’t know what the cause is until you see a provider. 

Seek immediate medical attention if you have bloody stool along with fatigue, fever, and/or vomiting. You also should not wait to get care if you have frequent and/or excessive amounts of blood in your stool.

Diagnosis

Before your healthcare provider can make a diagnosis and offer treatment, they will need to figure out the location and cause of the bleeding. They will first ask you questions about your symptoms and medical history.

First, they’ll ask you questions about your symptoms and medical history. For example, if you’ve had changes in bowel habits (like constipation or diarrhea). They will also want to know the location of any pain you’ve been having.

Next, your provider will do a rectal exam. During the exam, they will insert a gloved, lubricated finger into the anus. It’s a useful test that’s over quickly and won’t hurt. 

Your provider may recommend/perform one of these tests to figure out why you have bloody stool:

• A fecal occult blood test (FOBT) checks for blood in the stool. You will have to collect a stool sample at home and drop it off at a healthcare provider’s office or a laboratory.
• Blood tests measure substances in the blood to see if your immune system is working correctly. They can also diagnose or monitor certain diseases and conditions.
• A colonoscopy looks at the inside of the rectum and colon using a small scope (endoscope). This test is used to look for colon polyps and cancer.
• A sigmoidoscopy looks at the lower part of your colon (sigmoid colon). It’s less invasive than a colonoscopy, as it only checks the lower third of the colon (a colonoscopy looks at the entire colon).
• A gastroscopy (esophagogastroduodenoscopy), uses an endoscope to check the upper gastrointestinal tract, from the mouth to the stomach. This test looks for abnormalities such as ulcers, cancer, infection, and bleeding.
• A stool culture checks stool to see if pathogens such as bacteria could be causing an infection. Similar to FOBT, it requires you to collect a stool sample at home and drop it off at a healthcare provider’s office or a laboratory.
• A barium swallow (esophagogram) is a test that looks for abnormalities in the upper gastrointestinal tract using X-rays. Before taking the images, you will drink a liquid containing barium sulfate, which outlines the walls of the esophagus and upper gastrointestinal tract, making it easier to see in the pictures.

Summary

Red-colored stools can be caused by foods you eat or bleeding somewhere in your gastrointestinal tract. When red stools are caused by blood, it can be from a fairly simple cause like hemorrhoids or anal fissures. However, it can be a warning sign for conditions like colon polyps or cancer.

Blood in the stool is never normal, but it’s not always a sign of something serious. You should see your provider if you are noticing red stools and are not sure what’s causing it. If you have severe pain, a lot of bleeding, or vomiting along with the blood in your stool, get medical attention right away.