If there is painless bleeding with stool or just before the stool passing then there maybe internal hemorrhoids, per rectal examination and proctoscopy is advised to visualize the cause of the bleeding it is helpful to the 10 cm from the anal verge, if there is no lesion then colonoscopy is advised.
If there is painful bleeding then per rectal examination and proctoscopy is contraindicated.
Treatment of fissure is with medications,if not relieved then surgery is advised.
Treatment of internal hemorrhoids is surgery.
Next Steps
Investigations per rectal examination and proctoscopy if feasible.
Health Tips
visit surgeon