Rectal bleeding after straining

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

At a glance

Bleeding after straining during a bowel movement is very common. It is usually caused by hemorrhoids or a small fissure — both of which are made worse by the increased pressure of straining. Addressing the straining (by treating the underlying constipation) is usually the most effective way to resolve the bleeding.

Why straining causes bleeding

When you strain during a bowel movement, you increase the pressure in the blood vessels of the anal and rectal area. This can:

  • Engorge hemorrhoids: causing them to swell and bleed
  • Cause small tears: the lining of the anus is delicate, and hard stools combined with pressure can cause minor fissures
  • Irritate existing conditions: if hemorrhoids or a fissure are already present, straining worsens them

What the bleeding typically looks like

Bleeding from straining is usually:

  • Bright red — indicating it comes from the anus or very low rectum
  • On the toilet paper when wiping
  • On the surface of the stool or dripping into the bowl
  • Brief — stopping within minutes

Addressing the cause

The most effective approach is to eliminate the need to strain:

  • Increase fibre intake: fruit, vegetables, whole grains, or a fibre supplement
  • Drink adequate water: two to three litres daily
  • Go when the urge comes: delaying allows stool to harden
  • Limit time on the toilet: if it is not happening within a few minutes, get up and try again later
  • Stool softeners: if dietary measures are not sufficient
  • Good toilet posture: feet elevated on a stool, leaning slightly forward

When to seek assessment

Bleeding after straining is usually benign, but seek assessment if:

  • Bleeding recurs frequently despite soft, easy-to-pass stools
  • The amount of blood is significant or increasing
  • Bleeding is accompanied by pain, change in bowel habits, or other symptoms
  • You are over 40 and have not had the bleeding investigated
  • You want reassurance about the cause

A single GP appointment can usually confirm whether the bleeding is from hemorrhoids or a fissure and provide appropriate advice.

Common questions

Why does straining cause rectal bleeding?

Straining increases pressure in the blood vessels around the anus and rectum. This can cause hemorrhoids to swell and bleed, or it can cause small tears (fissures) in the anal lining. Both are very common and usually resolve when straining is addressed.

Will it stop if I stop straining?

In many cases, yes. If the bleeding is caused by the mechanical effect of straining on the tissue — engorging hemorrhoids or causing minor tears — addressing the underlying constipation often resolves the bleeding. If bleeding persists even with soft stools, further assessment is appropriate.

How do I stop straining?

The key is making stools soft enough that they pass easily without effort. This involves adequate fibre (through diet or supplements), drinking enough water, going when the urge comes rather than delaying, and not spending prolonged time on the toilet. If constipation persists despite these measures, discuss further options with your GP.

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

  1. Emergency

    Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

    Call 911 or go to the ER.

  2. Today

    Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

    Call your doctor or go to urgent care.

  3. Soon

    Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

    Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

  • Heavy bleeding that will not stop
  • Bleeding with dizziness or feeling faint
  • Dark blood or black stool
  • Bleeding that recurs frequently despite soft stools

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

  • bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
  • fainting, a racing heart or trouble breathing
  • confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
  • sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
  • you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
  • redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
  • a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
  • black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

  • a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
  • pain that is getting worse over days, or severe pain that stops you sitting or sleeping
  • a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
  • trouble urinating
  • bleeding that is getting heavier or more frequent, or blood mixed into your stool
  • feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
  • not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

  • you have never had these symptoms checked by a doctor or nurse — whatever your age
  • you have had rectal bleeding for more than 3 weeks
  • your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
  • symptoms have not settled after a week or so, or keep coming back
  • you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
  • you have new leakage or trouble controlling your bowels
  • you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

Showing US care routes. Change region at the foot of the page.

Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

  • About ten seconds a check-in. No app, no password.
  • Nothing in the subject or preview says what it’s about.
  • Each Sunday, a link to your week, ready for your next appointment.
Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00
Example. Nothing on the lock screen hints at symptoms or conditions.

Explore more

Related guides

When to worry about rectal bleeding

A practical guide to understanding rectal bleeding — which patterns are common and benign, which need medical attention, and when to seek urgent care.

Rectal bleeding: what it might mean

Learn about common causes of rectal bleeding, what the colour and pattern may indicate, when it is likely benign, and when to see a doctor urgently.

Managing constipation: common tips

Learn about common approaches to managing constipation, what people report helps, what tends to make things worse, and when to seek medical care.

Hemorrhoids: patterns and care

Learn what hemorrhoids are, the difference between internal and external types, what people commonly experience, what tends to help.

Related experiences

Bright red blood when wiping

The experience of noticing bright red blood on toilet paper — the panic, the googling, the common causes.

Anal fissure recovery diary

A composite diary following the daily reality of managing a chronic anal fissure — the routines, the setbacks, and the slow progress people describe.

Anonymous health forums: finding support

What people describe about finding community in anonymous health forums for colorectal conditions — the value, the risks, and the emotional impact.