Blood in stool (dumi na may kasamang dugo): causes, colours and when to get help

Blood in stool means blood that comes out with your poo (stool, dumi or tae). It can come from anywhere in the digestive tract, from the food pipe (esophagus) and stomach down to the colon, rectum and anus.

You may notice:

• bright red blood on the toilet paper, or red streaks on your poo
• pink or red water in the toilet bowl
• dark red blood mixed into the poo, or bloody diarrhea
• black, sticky, tar-like poo that smells very bad

Doctors call black, tarry poo melena, and red blood from the bottom hematochezia. Sometimes the blood is too little to see (hidden or occult blood), and only a stool test finds it.

The colour is a clue to where the blood comes from, not proof.

• Bright red blood usually comes from low down: the anus, rectum or colon.
• Dark red blood, or blood mixed into the poo, can come from further up the bowel.
• Black, tarry poo usually means bleeding higher up, in the esophagus, stomach or first part of the small intestine (the duodenum). Blood turns black as it is digested on the way down.

Food and medicines can change the colour too. Poo can look black after iron tablets, dishes cooked with blood such as dinuguan, blueberries, black licorice, activated charcoal or stomach medicines with bismuth. It can look red after red or purple foods such as beets, tomatoes or red dragon fruit, or red food colouring.

If you are not sure whether it is food or blood, a simple stool test can tell. Food and iron do not make you dizzy or weak: if you feel that way, treat it as bleeding and go to the emergency room.

At or near the anus (usually bright red blood):

• almoranas (hemorrhoids), swollen veins that bleed, itch or form lumps; see our hemorrhoids guide
• an anal fissure, a small tear that hurts sharply when you poo, often after constipation
• an injury, an anal fistula (which can leak yellow slime with blood), or a sexually transmitted infection

In the bowel:

• infections that cause bloody diarrhea (dysentery), such as amoeba (amoebiasis) and Shigella from unsafe water or food; see our diarrhea guide
• inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease, or a bowel that gets too little blood flow
• diverticular disease: small pouches in the colon wall, where a blood vessel can burst
• polyps (small growths) and colorectal cancer

Higher up (often black poo):

• stomach or duodenal ulcers, most often from H. pylori germs or pain relievers called NSAIDs, such as aspirin, ibuprofen, naproxen and mefenamic acid; see our peptic ulcer guide
• gastritis (an irritated stomach lining), for example from heavy drinking, or a sore esophagus from acid reflux
• swollen veins in the esophagus (varices), mostly in people with liver cirrhosis
• a tear in the esophagus after hard, repeated vomiting
• growths or cancer in the esophagus or stomach

Blood thinners such as aspirin, warfarin or clopidogrel make all of these bleed more easily.

Go to the nearest emergency room or call 911 now for a lot of blood, bleeding that will not stop, black, sticky, very smelly poo, vomiting blood, dizziness or fainting (see the red box). Do not drive yourself: ask someone to take you, and bring your medicines. Under the Anti-Hospital Deposit Law (RA 10932), a hospital cannot refuse first emergency treatment or ask for a deposit before giving it.

See a doctor today if your poo is dark red, or darker than usual and you are not sure iron tablets or food explain it, and you feel well. Bloody diarrhea also needs a check today.

Book a check-up if bleeding comes and goes, or your poo has changed, for 3 weeks, or if you are more tired than usual, losing weight, or have belly pain or a lump in your belly.

A tiny streak once, after a hard poo, is less worrying, but mention it at your next check-up.

Home care does not treat the cause, but it keeps you safer and helps the doctor:

1. Write it down: the colour, how much, how often, and whether the blood is on the paper, in the bowl or mixed in. A phone photo helps. List your medicines, herbal products and recent foods.
2. Avoid NSAID pain relievers such as ibuprofen, mefenamic acid and aspirin unless your doctor prescribed them. Ask a pharmacist what you can take for pain.
3. Do not stop a prescribed blood thinner on your own. Call your doctor today.
4. With bloody diarrhea, see a doctor today, and meanwhile sip oral rehydration salts (ORS or oresol) or other fluids so you keep passing urine. Do not take anti-diarrhea medicine such as loperamide or leftover antibiotics: the right treatment depends on the germ, which a stool test finds.
5. Keep your poo soft with vegetables, fruit and water, go when you feel the urge, and do not strain. This is safe while you wait, and it helps if the cause turns out to be almoranas or a small tear.
6. Skip alcohol until you have been checked.

"Almoranas lang 'yan." Almoranas is common, but polyps, ulcers and colorectal cancer can bleed the same way. PhilHealth notes that colorectal cancer is the third most common cancer among Filipinos. Let a health worker confirm the cause.

"Galing sa init ng katawan o sa maanghang." The health sources we checked do not list body heat or spicy food as causes of bleeding. Spicy food can make an ulcer hurt more, but the bleeding still needs a check.

"Hihinto rin 'yan." A small bleed can stop. But slow, hidden bleeding can cause anemia (too few red blood cells), and early colorectal cancer often has mild or no symptoms.

"Nakakahiya ang rectal exam." Doctors and nurses are used to it, and it takes only a moment. You can ask for a male or female health worker, and for someone to stay with you.

Herbal remedies or the albularyo. No source we checked shows these stop bleeding from the gut. Do not let them delay a check, and tell your doctor about anything you use.

The doctor or nurse will ask what the blood looks like, since when, which medicines you take, about other symptoms, and whether anyone in your family had colorectal cancer or polyps.

They will check your blood pressure and pulse, press on your belly, and usually do a rectal exam: a quick check of the anus and rectum with a gloved finger.

Tests you may need:

• a complete blood count (CBC) to look for anemia
• stool tests: a fecalysis, a test for hidden blood (FIT or FOBT), or a test for germs
• an upper endoscopy: a thin, bendable tube with a camera, passed through the mouth to the stomach and duodenum
• a colonoscopy: a camera tube passed through the anus to see the whole colon. You take a laxative beforehand to empty the bowel, and polyps can be removed during the test.
• sometimes a CT scan

With heavy bleeding, the hospital may give fluids through a vein (IV) or a blood transfusion, and in some cases doctors can stop the bleeding during an endoscopy.

For bleeding that is not an emergency, start at your barangay health station, rural health unit (RHU), city health center or PhilHealth YAKAP clinic: find one near you. As of July 2025, PhilHealth says YAKAP check-ups are free (a private YAKAP clinic may charge up to ₱900 a year). Lab tests on the YAKAP list that your doctor orders are included, and if you need one, the doctor can refer you for a free colonoscopy at an accredited facility. See our PhilHealth YAKAP guide.

In the emergency room. PhilHealth's Outpatient Emergency Care Benefit (2025) covers emergency room care at accredited hospitals when you are treated and sent home within 24 hours, and non-injury bleeding is on its list. Items outside its fee schedule may still be charged.

If you are admitted. On PhilHealth's 2024 case-rate list, the newest we found in November 2026, PhilHealth pays the hospital and doctor, for example, ₱24,960 for a bleeding stomach ulcer and ₱11,700 for amoebic or bacterial dysentery. In a ward bed, its no co-payment policy says you may have nothing more to pay. Ask the billing office, and the Malasakit Center for help with any balance.

Screening. PhilHealth's 2025 standards offer colorectal cancer screening, starting with a yearly stool test for hidden blood (FIT), to adults aged 45 to 75 and to people at higher risk, such as those whose parent, sibling or child had colorectal cancer or certain polyps. If you already see blood, do not wait for screening. See our annual check-up guide and, for other belly symptoms, our stomach pain guide.

Not sure what to do? Ask our symptoms assistant or book a call with a nurse.

Children. A little blood in a child's poo most often comes from constipation, but any blood in a child's poo needs a doctor's check. See a doctor the same day if the child has bloody diarrhea. Go to the emergency room now if the child is very sleepy, too weak to drink, or has signs of dehydration (see the red box). Ask a doctor before giving a child any medicine.

Pregnancy. Iron tablets can turn poo black, and small tears at the anus are more likely in pregnancy and after giving birth. Still, tell your midwife or doctor about any blood or black poo, and ask before taking any medicine. See our prenatal check-ups guide.

Older adults. Gut bleeding and colorectal cancer become more common with age. If you take aspirin or a blood thinner, report any bleeding to your doctor.