Rectal Bleeding

Blood when you wipe? Get it looked at this week, not in two months.

Most bright red bleeding comes from hemorrhoids or a small tear called a fissure. It still needs an exam, because the rare serious cause can look exactly the same from the outside. We do that exam, a quick in-office anoscopy, in a 20-minute visit in Lehi, often the same day, and treat what we find on the spot.

Book a Same-Day Evaluation Call/Text (801) 514-7100

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Go to the emergency room instead if you have any of these

  • Heavy bleeding, a toilet bowl full of blood, or blood clots
  • Feeling dizzy, faint, weak, or short of breath
  • Black or tar-colored stool
  • Severe belly pain or a fever with the bleeding

A small amount of bright red blood on the paper or in the water, with you otherwise feeling fine, is not an emergency. It is a reason to be seen this week.

What bright red bleeding usually means

Blood that is bright red, on the toilet paper or dripping into the bowl, almost always starts within the last inch or two of the anal canal. The usual causes:

  • Internal hemorrhoids: painless bleeding, sometimes with a bulge that comes out during a bowel movement.
  • Anal fissure: a small tear; sharp pain with bowel movements and a streak of blood on the paper.
  • Less often: a polyp, inflammation, or, rarely, a cancer of the rectum or colon. These are why bleeding should be examined rather than assumed.

Darker blood, blood mixed into the stool, or bleeding with weight loss, anemia, or a change in bowel habits points higher up and needs a different workup. We will tell you if that is you.

Most bright red rectal bleeding in adults comes from hemorrhoids or a fissure
64% of U.S. colonoscopies done for bright red bleeding found hemorrhoids (76,000-exam study)
20 min is a typical visit here: history, gentle exam with anoscopy, and a plan

Do I need a colonoscopy?

Sometimes, and we will say so. Guidelines reserve a full colonoscopy for specific situations; for everyone else, an anoscopy in the office answers the question the same day. Our provider spent years in gastroenterology and knows when a scope is the right call.

What we can usually sort out in the office

  • Bright red blood on the paper or in the bowl
  • Bleeding with a known or suspected hemorrhoid, bulge, or itching
  • Sharp pain with bowel movements and a streak of blood (fissure)
  • Bleeding after childbirth or during constipation
  • A painful lump that appeared suddenly (thrombosed hemorrhoid)

We will send you for a colonoscopy if

  • You are 45 or older and have not had a screening colonoscopy in the last 10 years
  • A parent, sibling, or child had colon cancer or advanced polyps
  • The blood is dark, maroon, or mixed through the stool
  • You have anemia, unexplained weight loss, or a change in bowel habits
  • A stool test for blood came back positive
  • Bleeding continues after we treat what we found, or the exam does not explain it

If you need one, we coordinate the referral with a gastroenterologist and stay involved. If you do not, you have skipped a prep, a sedation day, and weeks of waiting.

Why we look with an anoscope first

A colonoscope looks at the whole colon from the inside; it is the right tool for polyps and cancer. It is a poor tool for hemorrhoids: studies that examined the same patients both ways found that anoscopy picked up internal hemorrhoids a flexible scope missed, and when anoscopy was added to more than 12,000 colonoscopies it found hemorrhoids the colonoscopy had not graded. Hemorrhoid banding is also a separate, awake, office procedure, so a colonoscopy that finds hemorrhoids usually ends with a referral or a prescription rather than treatment. Here, the exam and the treatment are the same visit.

What happens at the visit

1

Tell us what you are seeing

How much blood, what color, how often, any pain, and your health history. No question is too awkward; this is all we do.

2

A gentle exam with anoscopy

A short, lubricated scope about the size of a finger lets us see the inside of the anal canal. It takes a minute or two and needs no prep or sedation.

3

Treatment, or a plan, the same day

Hemorrhoids can be banded at that visit; fissures get a treatment plan; anything that needs a colonoscopy gets a referral we arrange for you.

Rachel Hansen, PA-C

You will be seen by Rachel Hansen, PA-C

Certified Physician Associate with a background in gastroenterology who has performed thousands of hemorrhoid banding procedures. She does every evaluation and procedure here herself.

Questions people ask us about bleeding

Usually not. Bright red blood on the paper or in the bowl most often comes from hemorrhoids or a fissure. Cancer is uncommon but real, which is why we examine rather than assume, and why we send you for a colonoscopy if your age, family history, or exam calls for it.
Streaks on the paper, a few drops in the water, or a pink tinge are typical of hemorrhoids and fissures. A bowl that looks full of blood, clots, feeling faint, or black stool means the emergency room, not us.
Painless bright red bleeding is the classic sign of internal hemorrhoids, which have no pain nerves. Sharp pain with bowel movements usually means a fissure. Either way, it is worth a look; painless bleeding is also the kind people ignore the longest.
Often, yes. We hold time for same-day and next-day evaluations. Book online to see the next opening, or call or text (801) 514-7100.
A conversation about your symptoms, a brief external exam, and an anoscopy, which takes a minute or two with no prep or sedation. If we find internal hemorrhoids we can usually band them at the same visit. The whole appointment is about 20 minutes.
Yes. If you are 45 or older and overdue for screening, have a family history of colon cancer, have dark or mixed blood, anemia, or weight loss, or if your exam does not explain the bleeding, we arrange a gastroenterology referral and share our findings with them.
Most plans do not require one; you can book online directly. TRICARE Prime, VA Community Care, and United Healthcare Medicare Advantage do require a referral from your primary care provider. See our insurance page.

Stop guessing. Get an answer this week.

A 20-minute visit in Lehi, often the same day. Evaluation and treatment at the same appointment.

Book a Same-Day Evaluation Call/Text (801) 514-7100

Pick a time online in 2 minutes. Most plans accepted.

Sources: AGA clinical practice update on hemorrhoids (2026) · Gralnek et al., findings in 76,186 colonoscopies for bright red bleeding (2013) · Korkis & McDougall, anoscopy vs. flexible endoscopy (1995) · Gomes et al., anoscopy added to 12,151 colonoscopies (2019) · USPSTF colorectal cancer screening (2021). This page is general information, not a diagnosis.