Najis berdarah (blood in poo, or berak darah) is usually caused by piles (buasir) or a small tear in the anus (anal fissure), especially after constipation, and a small amount of one-off bleeding is not usually serious (NHS). Bright red blood usually comes from near the bottom. Black or dark red poo, or bloody diarrhoea, needs an urgent check. Go to the emergency department if you are bleeding non-stop or passing a lot of blood or large clots. Piles, constipation and fissures are common in pregnancy and after giving birth. Because bleeding is sometimes a sign of bowel cancer, see a doctor if it lasts 3 weeks or comes with changes in your poo, weight loss or tiredness. This guide explains what different types of bleeding can mean and when to get help.
Najis berdarah: apa yang anda mungkin nampak
The NHS says you might be bleeding from the bottom if you notice:
- blood on your toilet paper;
- red streaks on the outside of your poo;
- pink water in the toilet bowl;
- blood in your poo, or bloody diarrhoea;
- very dark poo, which can be blood mixed in with poo.
Many readers search for "contoh najis berdarah" (what bloody poo looks like). The colour and what comes with it give clues to the cause, but the NHS advises: do not self-diagnose, and see a doctor if you are worried. Note that poo can look red if you have eaten a lot of red or purple foods such as tomatoes or beetroot (buah bit), and dark if you take iron tablets (NHS).
Darah merah terang: buasir, fisur dan lain-lain
For bright red blood on the toilet paper, streaks on the poo or pink toilet water, the NHS lists these possible causes:
| What you notice | Possible cause | More information |
|---|---|---|
| Bright red blood and pain when pooing, itchy bottom, lumps | Piles (buasir): lumps inside and around the anus | See our guide to buasir |
| Bright red blood and sharp pain when pooing, often after constipation; burning pain afterwards | Anal fissure: a small tear in the anus | Usually heals on its own (NHS) |
| Bleeding with or without lumps, itching or pain | Sexually transmitted infections such as genital warts, or damage from anal sex | See a doctor or sexual health clinic |
| Bright red blood without pain | A side effect of medicines that prevent blood clots, such as warfarin, apixaban or aspirin; broken blood vessels in the gut | Do not stop a prescribed medicine without talking to your doctor (NHS) |
Constipation is a common trigger for both piles and fissures. The NHS says you are likely to be constipated if you have not had a poo at least 3 times in the last week, or your poo is dry, hard or lumpy and you strain. See our guide to sembelit.
Najis berdarah dengan lendir atau cirit-birit
When blood is mixed in the poo, or comes with slime (lendir) or diarrhoea, the NHS lists these possible causes:
| What you notice | Possible cause |
|---|---|
| Bloody diarrhoea with clear slime, feeling and being sick | A tummy bug (gastroenteritis); see our guide to cirit-birit |
| Bloody diarrhoea, tummy cramps and pain, feeling bloated | Inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn's disease |
| Blood and yellow slime, an irritated anus and constant pain around the bottom | An anal fistula |
| Blood in poo with a change in pooing habits (looser poo, diarrhoea or constipation) and slime | Bowel polyps or early signs of bowel cancer |
The NHS advises asking for an urgent appointment if you have bloody diarrhoea.
Najis hitam atau merah gelap
Very dark or black poo can be harmless: the NHS says it happens if you take iron tablets or eat a lot of dark foods such as blueberries. But it can also be a sign of bleeding higher up, in the stomach or gut. The NHS lists:
- dark or black poo from bleeding in the stomach or gut, which can be from an injury or a side effect of medicines that prevent blood clots, or aspirin;
- dark blood or poo with tummy pain or cramps, which can be a stomach ulcer (see our guide to ulser perut).
The NHS advises asking for an urgent appointment if your poo is black or dark red. If you are taking iron tablets for kurang darah and are not sure, tell your doctor; a test can check for blood.
Berak berdarah semasa hamil dan selepas bersalin
Bleeding when you poo is a common worry during pregnancy and after giving birth. The NHS says:
- constipation is common during pregnancy and after giving birth, and it is safe to try simple diet and lifestyle changes when pregnant;
- piles can happen in pregnancy, causing itching, soreness, a lump, and bright red blood after a poo; constipation can cause them;
- an anal fissure is more likely if you are pregnant or have given birth vaginally.
To ease piles in pregnancy, the NHS suggests eating plenty of fibre (wholemeal bread, fruit and vegetables), drinking plenty of water, not standing or sitting for long periods, regular exercise, not straining, using moist toilet paper and patting rather than rubbing. A cloth wrung out in iced water can ease pain. Do not use a cream or medicine without checking with your doctor, midwife or pharmacist first (NHS).
If you take iron tablets, your poo may look dark (NHS). Tell your doctor or klinik kesihatan about any bleeding, especially black poo, bloody diarrhoea, heavy bleeding or tummy pain. During confinement (berpantang), keep drinking enough and eating fibre; see our guide to makanan berpantang.
Najis bayi dan kanak-kanak berdarah
The NHS advises seeing a doctor if your child has blood in their poo. Anal fissures are common in young children, and constipation is a common cause in children (NHS). As with adults, get urgent help if there is a lot of blood or bloody diarrhoea (NHS).
Bila perlu fikir tentang kanser usus
The NHS says bleeding from the bottom is sometimes a sign of bowel cancer, which is easier to treat if found early. Other symptoms of bowel cancer listed by the NHS include:
- changes in your poo, such as softer poo, diarrhoea or constipation that is not usual for you;
- needing to poo more or less often than usual, or often feeling you need to poo even after going;
- tummy pain, a lump in your tummy or bloating;
- losing weight without trying;
- feeling very tired or short of breath, which can be signs of anaemia.
A 2026 study from Hospital Canselor Tuanku Muhriz (Universiti Kebangsaan Malaysia) notes that in Malaysia most bowel cancers are diagnosed at an advanced stage, even though a stool screening test (iFOBT) is available, partly because few people take up screening. Among 246 patients having a colonoscopy, rectal bleeding was one of the symptoms linked to bowel cancer and precancerous growths. Many of these symptoms are common and usually have other causes, but they should be checked. See our guide to kanser usus.
Apa boleh dibuat di rumah
For piles and fissures, the NHS suggests:
- drink lots of fluid and eat plenty of fibre to keep your poo soft;
- do not ignore the urge to poo, do not push too hard, and do not spend longer than needed on the toilet;
- take paracetamol for pain; do not take painkillers with codeine (they can cause constipation), and do not take ibuprofen if your piles are bleeding;
- a warm bath can ease itching and pain; keep your bottom clean and dry and pat it dry;
- a pharmacist can suggest creams for piles and laxatives for constipation.
Home care is only for minor bleeding with a clear cause such as piles. It does not replace a check-up if bleeding continues, keeps coming back or comes with other symptoms.
Bila perlu jumpa doktor atau ke hospital
Go to the emergency department or call 999 (NHS) if:
- you are bleeding non-stop;
- there is a lot of blood, for example the toilet water turns red or you see large blood clots.
Do not drive yourself; ask someone to take you (NHS).
Ask for an urgent appointment (NHS) if:
- your poo is black or dark red;
- you have bloody diarrhoea;
- you have piles and painless bleeding, pus, or a very high temperature or feel generally unwell.
See a doctor (NHS) if:
- your child has blood in their poo;
- you have had blood in your poo for 3 weeks;
- your poo has been softer, thinner or longer than normal for 3 weeks;
- you are in a lot of pain around the bottom, or have a pain or lump in your tummy;
- you have been more tired than usual or have lost weight for no reason.
The doctor may examine your bottom with a gloved finger, ask for a poo sample, or refer you for tests (NHS). You can ask for a female doctor and to have someone with you during the examination (NHS). For general tummy pain, see our guide to sakit perut.
Frequently asked questions (FAQ)
Kenapa najis berdarah (why is there blood in my poo)?
The NHS says a small amount of one-off bleeding from the bottom is not usually serious and often goes away on its own. Common causes of bright red blood are piles (buasir) and a small tear in the anus (anal fissure), often after constipation. Other causes include a tummy bug, inflammatory bowel disease, some medicines, and less often bowel polyps or bowel cancer, so it is important to get bleeding checked.
Contoh najis berdarah: macam mana rupanya (what does blood in poo look like)?
The NHS lists blood on the toilet paper, red streaks on the outside of the poo, pink water in the toilet bowl, blood mixed in the poo or bloody diarrhoea, and very dark poo, which can be blood mixed in. Bright red blood is often from piles or a small tear in the anus, while the NHS says black or dark red poo can be a sign of bleeding in the stomach or gut and needs an urgent check.
Berak darah merah terang tapi tak sakit, bahaya ke (bright red blood without pain)?
The NHS says bright red blood without pain can be a side effect of medicines that prevent blood clots, such as warfarin, apixaban or aspirin, or from broken blood vessels in the gut. Piles can also bleed. The NHS advises an urgent appointment for painless bleeding if you have piles, and to see a doctor if you have had blood in your poo for 3 weeks.
Najis hitam, kenapa (why is my poo black)?
The NHS says poo can look very dark or black if you take iron tablets or eat a lot of dark foods such as blueberries. But black or dark red poo can also be a sign of bleeding in the stomach or gut, such as from a stomach ulcer. The NHS advises asking for an urgent appointment if your poo is black or dark red.
Berak berdarah semasa hamil atau selepas bersalin, normal ke (bleeding when pregnant or after birth)?
Piles and constipation are common in pregnancy and after giving birth, and an anal fissure is more likely if you are pregnant or have given birth vaginally (NHS). They usually cause bright red blood when you poo. Eat plenty of fibre, drink water and do not strain, and ask your doctor or midwife before using any cream. Tell your doctor about any bleeding so they can check the cause.
Najis bayi atau anak berdarah, apa perlu buat (blood in my child's poo)?
The NHS advises seeing a doctor if your child has blood in their poo. In young children, a small tear in the anus (anal fissure) is common and constipation is a common cause. Get urgent help if there is a lot of blood or bloody diarrhoea.
Bila najis berdarah perlu ke hospital (when should I go to hospital)?
Go to the emergency department or call 999 if you are bleeding non-stop, or there is a lot of blood, such as the toilet water turning red or large blood clots (NHS). Get an urgent appointment for black or dark red poo or bloody diarrhoea. See a doctor if bleeding lasts 3 weeks, your poo has changed for 3 weeks, or you have tummy pain, a lump, tiredness or weight loss.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Bleeding from the bottom (rectal bleeding) — NHS
- Piles (haemorrhoids) — NHS
- Piles in pregnancy — NHS
- Anal fissure — NHS
- Constipation — NHS
- Symptoms of bowel cancer — NHS
- Abdul Rahman KA, et al. Validation of multi-target stool DNA methylation test for colorectal cancer detection: a preliminary analysis. Biomedicines. 2026;14(5):999
