AbstractFecal management System (FMS) is widely used across medical facilities in United States. These devices have helped in preventing problems associated with fecal incontinence. Although highly efficient, these devices can also lead to certain complications including rectal ulcer and lower Gastrointestinal (GI) bleed. Here, we report a case of a 56-year-old male being treated for pneumonia and atrial fibrillation, who had significant lower GI bleed while being on FMS for stool incontinence. A colonoscopy was performed, which showed multiple rectal ulcers with one large ulcer having a visible pulsating vessel. This case highlights a rarely reported complication of rectal ulcers and GI bleed associated with use of FMS.