Common symptoms
- Bright red blood on the toilet paper or in the pan
- Dark red blood mixed in with the stool
- Black, tarry stools
- Iron deficiency anaemia — tiredness, breathlessness or pale skin
- Unexplained weight loss
- A persistent change in bowel habit
- A lump or pain around the back passage
- Abdominal pain
Conditions diagnosed and managed
- Rectal bleeding and blood in the stool
- Iron deficiency anaemia
- Unexplained weight loss
- Persistent change in bowel habit
- Bowel polyps, including large and complex polyps
- Haemorrhoids and anal fissures
- Family history of bowel cancer
- Abnormal bowel screening (FIT) result
- Investigation of suspected bowel and stomach cancer
Common causes of rectal bleeding
Most rectal bleeding is caused by common, benign conditions such as haemorrhoids (piles) or a small tear (anal fissure). Other causes include inflammation (colitis), diverticular disease and bowel polyps. Less commonly, bleeding is a sign of bowel cancer — which is why it should always be checked rather than assumed to be piles.
Blood in the stool: what does it mean?
The colour and pattern of bleeding give useful clues. Bright red blood on the paper is often from near the back passage; darker blood mixed in with the stool may come from higher in the bowel; black, tarry stools can mean bleeding from the stomach or upper gut. Whatever its appearance, persistent or recurrent bleeding should be investigated.
Iron deficiency anaemia and gastrointestinal problems
In men, and women after the menopause, iron deficiency anaemia is often caused by slow, unseen blood loss from the gut, or by poor absorption, for example in coeliac disease. It usually needs investigation with both a gastroscopy and a colonoscopy.
Bowel polyps and their significance
Polyps are small growths on the lining of the bowel. They are very common, and most are harmless, but some types can slowly turn into cancer over many years. Removing polyps during colonoscopy is one of the most effective ways of preventing bowel cancer.
Dr Khalid is an Advanced Therapeutic Endoscopist who removes large and complex polyps endoscopically using EMR, ESD and EFTR — techniques that can avoid the need for bowel surgery.
Understanding bowel cancer symptoms
Bowel cancer is one of the most common cancers in the UK, but it is highly treatable when found early. Warning symptoms include bleeding from the back passage, a persistent change in bowel habit, unexplained weight loss, abdominal pain or a lump, and iron deficiency anaemia. Having one of these symptoms does not mean you have cancer, but it does mean you should be checked.
When is a colonoscopy recommended?
A colonoscopy is the most accurate test for finding the cause of bleeding and for detecting and removing polyps. It is usually recommended for persistent bleeding, iron deficiency anaemia, a positive FIT or bowel screening result, a significant family history of bowel cancer, and for surveillance after polyps have been removed.
How Dr Khalid investigates the problem
Dr Khalid will take a careful history and perform an examination, which may include an examination of the back passage. Investigations may include:
- Blood tests for anaemia, iron levels and inflammation
- A FIT stool test
- A colonoscopy or flexible sigmoidoscopy, with biopsies and polyp removal at the same procedure where possible
- A gastroscopy if anaemia or black stools suggest an upper gut cause
- CT imaging where appropriate
Treatment and management
Many causes — such as haemorrhoids, fissures, inflammation and polyps — can be treated directly, often during the same procedure. As an accredited Bowel Cancer Screening Endoscopist and former National Clinical Assessor for the Joint Advisory Group (JAG) on Endoscopy, Dr Khalid works to the highest standards of colonoscopy quality and safety.
If cancer is found or suspected: Dr Khalid’s role is prompt, accurate diagnosis. He will explain the findings clearly and arrange urgent referral to the appropriate colorectal or upper GI cancer team, who will plan treatment.
When should you see a gastroenterologist?
Always seek advice about bleeding from the back passage, black stools, unexplained weight loss or anaemia. Do not wait to see if it settles — early investigation is reassuring when the cause is benign, and makes a real difference when it isn’t.
Book a private consultation at Spire Cheshire in Warrington or The Highfield Hospital in Rochdale.
When to seek urgent help
Don’t wait for a routine appointment. Call 999 or go to A&E if you have:
- Vomiting blood or material that looks like coffee grounds
- Black, tarry stools or heavy rectal bleeding
- Severe or worsening abdominal pain
- Food stuck and being unable to swallow
- Yellowing of the skin or eyes with fever or pain
Frequently asked questions
Is rectal bleeding always serious?
Most rectal bleeding is caused by haemorrhoids or a small tear, but it should always be checked by a doctor, particularly if it is persistent, mixed with the stool, or accompanied by a change in bowel habit, weight loss or anaemia.
Can polyps be removed during a colonoscopy?
Yes. Most polyps can be removed during the same colonoscopy. Dr Khalid also specialises in removing large and complex polyps using advanced endoscopic techniques such as EMR, ESD and EFTR, which can avoid the need for surgery.
Does Dr Khalid treat bowel cancer?
Dr Khalid’s role is to investigate and diagnose. If cancer is found or suspected, he will arrange urgent referral to the appropriate cancer team, who will plan and deliver treatment.
I have a family history of bowel cancer. Should I have a colonoscopy?
Depending on how many relatives were affected and at what age, you may benefit from earlier or more frequent colonoscopy. A consultation can assess your risk and advise on the right screening plan.
Medically reviewed by Dr Sal Khalid, Consultant Gastroenterologist. Last reviewed November 2026. This page is general information and does not replace a personal medical consultation.