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Johns Hopkins Health Alert

Bleeding in the Digestive Tract

Blood in your stool could be a sign of a serious condition, or something more benign, like a hemorrhoid. Johns Hopkins reviews common causes of bleeding in the digestive tract.

Vomiting blood or finding it in your stool can be frightening, because it is a sign that you are bleeding somewhere in your digestive tract and you may have a digestive disorder. But not all causes of gastrointestinal bleeding are ominous. For instance, bleeding from the rectum can be caused by hemorrhoids, which are uncomfortable but definitely not life threatening.

In addition, taking iron supplements or the antidiarrhea medication bismuth subsalicylate (Pepto Bismol) or consuming foods such as beets can all make your stool look like it has blood in it when, in fact, it doesn’t. Still, all cases of suspected bleeding in the digestive tract should be evaluated by your doctor, so that the underlying problem can be identified and treated if necessary.

Bleeding Symptoms -- Bleeding in the digestive tract doesn’t always produce obvious signs --it depends on where the bleeding is occurring and how severe it is. For instance, colon cancers bleed only intermittently and typically produce small amounts of blood that can only be detected on special stool tests.

Other times, bleeding is obvious -- bright red or darker red blood in the stool, in the toilet bowl, or on the toilet paper when you wipe your anus. Bright red blood is a sign of active bleeding in the rectum or large intestine (colon). When the blood is a darker red, the bleeding is occurring higher up in the colon or in the lower portion of the small intestine.

If your stools are black and tarry, the bleeding is taking place in the esophagus, stomach, or upper portion of the small intestine. The dark color of the blood results when blood is exposed to the acid, enzymes, and bacteria in the stomach and intestines.

Blood may also be visible in vomit, when bleeding is occurring in the esophagus, stomach, or upper small intestine. The blood is bright red when vomiting occurs soon after bleeding begins. If you see coffee grounds-like material in your vomit, this means the blood has been in your digestive tract for awhile -- long enough to be partially digested by the acid in your stomach.

Here’s a list of some of the common causes of bleeding in the digestive tract:

Bleeding in the Esophagus:

  • Ulcer
  • Inflammation (esophagitis)
  • Rupture of enlarged veins (varices)
  • A tear in the esophageal lining (Mallory-Weiss syndrome)
  • Cancer

Bleeding in the Stomach:
  • Ulcer
  • Inflammation (gastritis)
  • Rupture of enlarged veins (varices)
  • Benign tumors
  • Cancer

Bleeding in the Small Intestine:
  • Ulcer
  • Inflammation (Crohn’s disease)
  • Polyps
  • Cancer

Bleeding in the Large Intestine, Rectum, and Anus:

  • Infections
  • Inflammation (ulcerative colitis or Crohn’s disease)
  • Polyps
  • Cancer
  • Diverticular disease
  • Hemorrhoids
  • Anal fissures

Posted in Digestive Health on February 4, 2008
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


I'm experiencing gas in my stomach every day. I have candida in my stool, but not in my stomach. I have acid reflux disease. I have hemorrhoids. I'm presently taking omeprazole for acid reflux disease. My questions are. Why I can't get rid of the gas in my stomach? Why I can't get rid of the candida in my stool? Why I can't get rid of the hemorrhoids. I had a test done of my stomach, and it showed my gastrointestinal tract is very irritated.

Posted by: battistaphil | May 3, 2009



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