Rectal bleeding means any blood that you see when you have your bowels open - in the toilet on or in the poo or on the toilet paper.
Some people assume that if they see blood only on the toilet paper after cleaning themselves, this is from piles and is not important. Usually they are right – most rectal or anal bleeding is pretty normal. It comes from veins we all have just inside the back passage or anus. These veins are normal structures, although in some young people they can be quite large. The bleeding can occur for no obvious reason although it can be caused by straining or from small abrasions to the skin caused by hard motions or stools
However, bleeding becomes more significant the older you get - particularly when you are over 50.
Most people feel they don’t need to take any notice if the blood is fresh and bright red. Although this sort of bleeding is less worrying, you should report it to a doctor if it persists. Dark red, old or altered bleeding may be more significant, but it can still be from something simple like piles.
Rectal bleeding is very common, particularly in people below the age of 50. Seven million people (almost 1 in 5 of the population!) have it every year in the UK but only one in a thousand (0.1%) will have serious disease.
Most people (over 6 out of 10) do not report bleeding to their doctor immediately, probably because it stops quickly or they have been straining to pass a hard or dry stool. The doctor might say you are bleeding from your piles as a way of reassuring you that the bleeding isn’t serious. For most people, it requires no further treatment and stops by itself.
Some patients use creams and suppositories from the chemist to treat symptoms like soreness, pain, burning, discomfort, itchiness, lumpiness or prolapse of the veins around the anus. Prolapsed piles may require pushing back by hand after cleaning.
Remember - it is almost normal to have rectal bleeding for some simple reason for the majority of people. But the older you are (over 50), if you have no reason for the bleeding and it persists, do see your GP.