Rectal bleeding that comes and goes

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

At a glance

Rectal bleeding that appears, settles, and then returns is one of the most common patterns people experience. It is usually caused by hemorrhoids or fissures that flare and improve depending on stool consistency, diet, and other factors.

This intermittent pattern can create a particular kind of anxiety — the bleeding seems to go away, which provides relief, and then returns, which triggers worry all over again.

Common causes of intermittent bleeding

Hemorrhoids

The most common cause. Hemorrhoid bleeding typically correlates with:

  • Periods of constipation or harder stools
  • Straining
  • Dietary changes
  • Prolonged sitting
  • Stress

When these factors improve, the bleeding settles. When they return, so does the bleeding.

Anal fissure

Fissures can partially heal and then re-tear, creating episodes of bleeding separated by pain-free periods. This is common with chronic fissures that have not fully resolved.

Dietary and lifestyle factors

Changes in diet, hydration, activity level, and stress can all affect bowel function and cause intermittent bleeding without a significant underlying condition.

Why the pattern matters

The fact that bleeding comes and goes is actually useful information:

  • Bleeding that correlates with constipation or straining strongly suggests hemorrhoids or fissure
  • Bleeding that occurs independently of bowel habits may warrant more thorough investigation
  • Bleeding that is becoming more frequent or heavier over time should be assessed
  • Bleeding that is always in the same pattern (e.g., only with hard stools) is more likely benign than bleeding that is unpredictable

When to get it checked

Even benign intermittent bleeding should be assessed at least once to confirm the cause. Seek assessment if:

  • The pattern has been present for more than a few weeks
  • Episodes are becoming more frequent
  • The amount of blood is increasing
  • There are other symptoms — change in bowel habits, mucus, weight loss, pain
  • You are over 40 and have not had an assessment
  • The anxiety about the bleeding is affecting your quality of life

Managing the pattern

If the cause has been confirmed as hemorrhoids or fissure, managing the intermittent pattern involves:

  • Maintaining soft stools consistently — not just during flare-ups
  • Addressing constipation promptly when it begins
  • Adequate fibre and hydration as a daily habit, not a reactive measure
  • Monitoring for changes in the pattern that would warrant reassessment

The goal is to reduce the frequency and severity of flare-ups through consistent self-care, rather than reacting to each episode individually.

Common questions

Why does rectal bleeding come and go?

Intermittent bleeding is characteristic of conditions like hemorrhoids and fissures, which flare and settle depending on factors like stool consistency, straining, diet, and stress. Bleeding during flare-ups and no bleeding during quieter periods is a very common pattern.

Should intermittent bleeding be investigated?

If the pattern has been present for more than a few weeks, or if the episodes are becoming more frequent or heavier, investigation is worthwhile. Even if each episode seems minor, a recurring pattern deserves at least one assessment to confirm the cause.

Can hemorrhoids cause bleeding that comes and goes?

Yes. This is one of the most typical presentations of hemorrhoids. Bleeding occurs during flare-ups — often triggered by constipation, straining, or dietary factors — and then settles, sometimes for weeks or months, before recurring.

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:

  • Bleeding that becomes heavy or persistent
  • Bleeding with unexplained weight loss or change in bowel habits
  • Dark red or black stool at any point
  • Bleeding with dizziness, fatigue, or feeling faint

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.

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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.

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Rectal bleeding after straining

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Hemorrhoids: patterns and care

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