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Most people report that hemorrhoids make anal sex uncomfortable or painful, and because a hemorrhoid is literally an enlarged, swollen blood vessel, they can certainly cause anal bleeding after. Though it may be alarming, light spotting immediately after is possible. But if youre experiencing heavier bleeding, it could be a sign. , a colorectal surgeon at cedars-sinai in los angeles, tells self. even though serious injury from anal sex is not common, it can occur. Bleeding after anal sex could be due to a hemorrhoid or tear, or something more serious such as a perforation (hole) in the colon. But then, without warning, you see a streak of bright red blood on your tp. The bleeding may result in bright red blood in the stool as well as maroon colored or black stool. The bleeding also may be occult (not visible with the human eye). The common causes of rectal bleeding from the colon include anal fissure, hemorrhoids, diverticulosis, colon cancer and polyps, colonic polyp removal, angiodysplasias. We look at 11 causes here, along with the treatment options there are for each one. Rectal bleeding (bleeding from the bottom) is often noticed as small amounts of bright-red blood on toilet paper or a few drops that turn the water in the toilet pink. Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area. Non-surgical treatments are recommended initially for acute and chronic anal fissures. These include topical nitroglycerin or calcium channel blockers (e. Diltiazem), or injection of botulinum toxin into the anal sphincter.