Dear Alice,

What does it mean if there is blood in your stool? Is it serious or should I worry?

Dear Reader,

There are lots of different medical conditions that can cause blood to appear in a person's stool. They range from the very minor to the very serious, and may include:

  • Anal fissures, which are small cracks or tears around the anus that can be caused by large and/or forceful bowel movements or anal sex (including insertion of fingers, sex toys, etc.);
  • Hemorrhoids (a.k.a. piles), which are enlarged veins in the lower part of the rectum or anus;
  • Infection or disease in the GI (gastrointestinal) tract such as bacterial infections, stomach ulcers, or inflammatory bowel disease (IBD);
  • Tumors or cancer of the GI tract such as polyps or colon cancer.

Only a health care provider can determine whether the blood in your stool is from straining too hard, or from a more serious and/or long-term medical problem. People who experience blood in their stool are urged to seek medical advice to rule out any serious problems.

Before your appointment, it’s good to consider and observe a few things which you can then report to your health care provider. First, how much blood is there? Whether there is a small or large quantity of blood present, it could be cause for worry. A large quantity of blood (say enough to color the water in the toilet pinkish-red or show up as visible clots) can be a sign of a life-threatening bleed in the GI tract, which requires emergency medical treatment. Small amounts of blood may not necessarily mean a small problem, though — for example, one of the early signs of colon cancer is the presence of minute amounts of hidden (or occult) blood in stools — so any amount of blood in the stool needs to be followed up with a call to your health care provider. Second (or #2), what color is your stool? Bleeding in the GI tract can produce stools that are maroon-colored or black and tar-like. However, some foods and medicines can also cause black or tar-like stools (including blueberries, black licorice, and pink bismuth) or maroon ones (e.g., beets).

Best of luck figuring out the cause!

Take care,


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