While the majority of people with peptic ulcers have no symptoms, the most common symptom you might experience is abdominal pain, the Mayo Clinic says. However, in less common and more severe cases, you can also end up with dark blood in your poop. “It can look like driveway tar—it’s shiny and sticky and has a peculiar odor to it,” Gail Bongiovanni, M.D., a gastroenterologist and adjunct professor in the division of digestive diseases at the University of Cincinnati College of Medicine, tells SELF. This dark stool is also known as melena and can have a consistency like peanut butter. If you notice it, it suggests that you need an evaluation of your upper intestinal tract to locate the source of the bleeding.
Though these are two different forms of inflammatory bowel disease (IBD), both Crohn’s and ulcerative colitis can cause chronic inflammation in your digestive tract that leads to bleeding ulcers, hence you pooping blood.
In case you’re not familiar with it, Crohn’s disease is a chronic disease that causes inflammation and irritation in your digestive tract, usually in your small intestine and the beginning of your large intestine, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)10. Ulcerative colitis is a chronic disease that causes irritation or swelling and sores called ulcers on the inner lining of your large intestine, the NIDDK11 says.
8. Blood in your poop could be a sign of colorectal cancer.
Bright red rectal bleeding can sometimes be due to colorectal cancer, according to the American Cancer Society12. Colorectal cancer is tough to pin down—it may not cause symptoms right away, the American Cancer Society says, and when it does, rectal bleeding can show up alone or with other issues. You might also experience things like diarrhea, constipation, a persistent urge to poop, a change in your stool shape or size (i.e., they become pencil-thin), abdominal pain, weakness and fatigue, and unintended weight loss.
Risk factors for colorectal cancer include a personal or family history of colorectal polyps, a personal or family history of irritable bowel disease like Crohn's colitis or ulcerative colitis, being Black, and being above 45, according to the American Cancer Society13. (However, colorectal cancer rates are significantly on the rise in people younger than this.)
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What to do when you're pooping blood
Not to sound like a broken record here, but the whole “Call your doctor” advice comes up a lot with this kind of stuff for a reason. Still, sometimes you can try out a few things on your own. Of course, the advice is a little different depending on what you might be dealing with.
If it’s hemorrhoids:
First things first: If you see blood in your poop and are over 45, Black, or have a family history of colorectal cancer, you should see a doctor to rule out other causes before deciding you must just have hemorrhoids.
However, if you do actually have hemorrhoids, they usually clear up on their own. Still, they can stick around and cause persistent bleeding, Dr. Farhadi says. If hemorrhoids are indeed your issue, Dr. Farhadi recommends eating high-fiber foods to try to soften up your waste so pooping won’t require Herculean effort. (Be sure to also drink enough water, since the fiber soaks it up to help make poop softer and easier to pass.)
If it’s an anal fissure:
Christine Lee, M.D., a gastroenterologist at Cleveland Clinic, likens anal fissures to having a paper cut on your butt. Yowza. Luckily, they usually get better on their own, though you can ask a doctor which anesthetic-containing cream they recommend to dull the pain in the meantime. It can also help to take a sitz bath and increase your fiber intake (so that your future poops are a little more manageable), according to the Mayo Clinic14.
If it’s a polyp in your colon:
Most of these polyps are harmless, but a small portion of them can develop into colon cancer over time. Doctors treat colon polyps by removing them endoscopically (using a flexible camera with a light, also called an endoscope), then making sure they’re not cancerous, says the NIDDK.
If it’s diverticulosis:
Diverticular bleeding sometimes stops on its own. If that's not the case for you, your doctor may do a colonoscopy to figure out where the bleeding is happening so they can put an end to it.
If it’s E. coli:
The good news: Healthy adults usually recover from E. coli in about a week, the Mayo Clinic9 says. In general, resting and drinking plenty of fluids to help prevent dehydration is the main thing to do. The bad news: E. coli that causes bloody diarrhea can make people sick enough to wind up in the hospital. At the hospital, you can receive supportive care, like IV fluids, blood transfusions, and kidney dialysis if necessary.
Even if your E. coli is tame enough that you can recover at home, don’t take anti-diarrheal medication, the Mayo Clinic warns. It slows down your digestive system and prevents your body from getting rid of the toxins.
If you have a peptic ulcer:
Doctors may prescribe drugs to neutralize irritating stomach acid or medications to help protect the tissues that line your stomach and small intestine, the Mayo Clinic2 says. In the event that your peptic ulcer is bleeding, you will need a procedure known as an upper endoscopy so a gastroenterologist can treat the bleed and stop it from bleeding again.
If your doctor suspects Crohn’s disease or ulcerative colitis:
IBD treatment courses vary from person to person, but they can involve taking anti-inflammatory drugs like corticosteroids to tame inflammation, immunosuppressants to stop your immune system from attacking your digestive tract, and medicine to combat symptoms like diarrhea and constipation, according to the Mayo Clinic14. Your doctor may also recommend surgery if other treatments haven’t helped as much as they should. Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.
If you’re concerned it might be colorectal cancer:
Seek medical attention as soon as possible, especially if you have any of the aforementioned risk factors.