Possible causes may be hemorrhoids, fissures etc...fresh bleed with itching goes in favor of hemorrhoids...You need immediate surgical attention.. Consult nearest surgeon for clinical examination as treatment depends upon clinical grading The following is a quick summary of treatment for internal hemorrhoids by grade: Grade 1 hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs and spicy or fatty foods Grade 2 or 3 hemorrhoids are initially treated with nonsurgical procedures Very symptomatic grade 3 and grade 4 hemorrhoids are best treated with surgical hemorrhoidectomy Treatment of grade 4 internal hemorrhoids requires prompt surgical consultation..