Blood on toilet paper after pooping: what should I do?

What should I do right now?

The NHS sorts the warning signs by urgency:

Call 999 or go to A&E if:

• you’re bleeding non-stop
• there’s a lot of blood, for example the toilet water turns red or you see large blood clots

The NHS adds: don’t drive yourself to A&E.

Ask for an urgent GP appointment or call NHS 111 if:

• your poo is black or dark red
• you have bloody diarrhea

See a GP if:

• you have blood in your poo, or bleeding from your bottom that comes and goes or lasts weeks
• you have other changes like looser or more frequent poo, weight loss or tiredness

If none of the urgent signs apply, you have time to make a normal GP appointment. Do make it.

What usually causes bright red blood on the paper?

Two common causes the NHS describes:

	Piles (hemorrhoids)	Anal fissure
What it is	Lumps inside and around your bottom	A small tear in the skin of your anus
Typical signs	Bright red blood after a poo, itchy bottom, lumps, mucus on the paper, feeling you still need to go	Severe, sharp pain when you poo, burning pain after that can last hours, bright red blood
Self-care the NHS suggests	Fluids and fiber, don’t push or linger, cut down on alcohol and caffeine	Fluids and fiber, warm shallow bath after a poo, don’t ignore the urge
See a GP if	Getting worse, not improving, or keeps coming back	No better after 7 days of self-care

Even if this table sounds like you, see a GP to confirm it. Other causes of bleeding, including bowel cancer, can look similar, and the NHS bowel cancer page lists blood in your poo among its symptoms. Most of the time it’s not cancer, but that’s for a doctor to decide.

Is it really blood?

Red foods can fool you. The NHS says beetroot and tomatoes can make poo look red. Food color is usually mixed through the poop, while fresh blood tends to be on the paper or in the water. See beetroot poop.

How do I help it settle while I wait?

From the NHS piles and fissure pages:

• drink plenty of fluids and eat plenty of fiber to keep poo soft
• don’t ignore the urge, and don’t strain or sit on the toilet longer than you need to
• cut down on alcohol and caffeine (piles)
• a warm, shallow bath after a poo can ease fissure pain
• keep the area clean and pat it dry

Our constipation guide has more on keeping poo soft.

What should I note for the GP?

Mon 08:10  Poop: type 2
Mon 08:10  Paper note: bright red on paper, sharp pain
Tue 08:30  Poop: type 3
Tue 08:30  Paper note: a little blood, less pain
Wed 08:00  Poop: type 4
Wed 08:00  Paper note: no blood

Bring dates, the color of the blood (bright red or dark), whether it was on the paper, in the water or mixed in, any pain, and your Bristol types. PoopAI can keep the Bristol log for you; the blood notes are yours to add, since the app doesn’t read color.

Wrap-up

Blood on the paper is scary and usually explainable. Piles and small tears are common, and softer poop helps both. But don’t diagnose yourself from a table on the internet, this one included. Check the urgent signs, then book a GP appointment.

3C. IBS and FODMAP