HI there.

Blood in the stool can indicate a variety of problems. Bright red blood often indicates problems occurring in the lower sections of your digetive tract (large intestine, rectum). The most common causes of bright red blood are hemorrhoids, anal fissure, and diverticulitis. Black and tarry looking stool ussually indciates bleeding from the upper part of the digestive tract (esophagus, stomach, small intestine).

Considering you notice the blood mostly on the tissue, the most likely cause is hemorrhoid (although anal fissure is not completely ruled out). Hemorrhoids are dilated blood vessels and depending on their location may feel like a bump around the anus. They are often itchy, painful, and if broken can produce bright red blood with bowel movements or on the tissue after wiping. Becuase you have a history of internal hemorrhoids, this is the most likely possibility.

I would suggest you see your doctor for further evaluation and treatment. Although this may be as simple as a hemorrhoid, other more concerning conditions must be ruled out. Pain and bleeding during bowel movements should always be evaluated to determine the exact cause.

You can find more information about blood in the stool and rectal bleeding here: http://www.emedicinehealth.com/rectal_bleeding/article_em.htm

I hope you find this information helpful.

-Dr.John

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