Blood in the stool may be caused by irritation of the bowel during a bowel movement. It can also be caused by straining very hard, by an ulcer or a tumor in the bowel, by hemorrhoids (enlarged blood vessels in or around the anus), a pressure sore or ulcer in the anal area, or a low platelet count (see the section on blood counts).

What to look for

• Blood on toilet tissue
• Blood on underwear, sheets, or underpads
• Streaks of blood in stool
• Bright red blood from rectum
• Dark red or black bowel movements (But remember that eating beets can cause red stools, and iron tablets or bismuth medicines such as Pepto-Bismol^® and Kaopectate^® can temporarily cause black stools. This is normal.)

What the patient can do

• Check how much blood is being passed.
• Avoid placing anything in the rectum, including suppositories, enemas, thermometers, etc.
• Keep stool soft by taking in plenty of fluids and fiber.
• Use stool softeners, and avoid enemas or laxatives.
• Wash anal area very carefully with warm, soapy water, rinse well, and pat dry.
• A sitz bath (sitting in warm water) may be helpful for hemorrhoids.

What caregivers can do

• Help the patient watch for bleeding.
• Offer extra fluids, fruits, and vegetables to keep stool soft.

Call the doctor if the patient:

• has blood on toilet tissue 2 or more times
• has blood streaks in stool
• has bright red blood from rectum
• has dark red or black stools

Go to a list of symptoms to find other problems in Caring for the Patient with Cancer at Home: A Guide for Patients and Families.

Revised: 04/07/08