Hi Dr. Narasi, I have some bright red blood on the outside of the stool ,on the toilet paper and some pain that feels like its at the end of the anus . I paid a visit to the gastroenterologist about 3 years ago for the same issue. Dr. performed a flexible sigmoidoscopy and said there was no sign of cancer. But he said there was a I believe a fissure and an internal hemmoroid. He prescribed Calmol 4(zinc and cocoa butter inserts) and told me to increase my fiber intake. I did this off and on for a while and over the last 3 years the condition would come and go with periods of bright red bleeding. Lately the pain has returned as has the bright bloo, and I notice the pain sometimes lingers for hours after a bowel movement . I notice blood stains on my underwear almost as if I continue to bleed lightly after a bowel movement. I have an appointment tomorrow with the gastro and have no idea what else can be done. Could this be something more serious this time around? is there any way for me to cure this once and for all as it is a real hindrence. I am 40 year old male in good shape. Thank you