Gastroenterology clinic

Bright red blood on the toilet paper

Gastroenterology clinic

Bright red blood on the toilet paper

Gregor Brown

Abstract

Occasional bright red rectal bleeding is common and may not require any therapy once a sinister cause has been excluded. Here, Dr Brown outlines his approach to per rectal bleeding.

Article Extract

Remember
  • It is useful to distinguish outlet bleeding (bright red rectal bleeding seen on the toilet paper or in the bowl) from altered bleeding (dark blood, and/or mixed in with stool), as the latter suggests a non-anal and probably more serious cause.
  • Intermittent minor bright rectal bleeding is common, and usually due to benign anal pathology such as haemorrhoids or anal fissure (Figure 1).
  • Important but less common causes include cancer, large polyps, inflammatory bowel disease and radiation proctitis.