Hi, Rectal bleeding can be a concerning symptom, and it s important for your brother to follow up with his doctor to determine the underlying cause. While stool softeners can be helpful for some individuals with constipation, they may not be effective for all cases of rectal bleeding. It s also important to note that not all causes of rectal bleeding will result in visible blood in the stool. Some possible causes of rectal bleeding include: 1. Hemorrhoids: This is a common cause of rectal bleeding and occurs when the veins in the rectum or anus become swollen and irritated. Your brother s doctor may have ruled out hemorrhoids based on the stool test. 2. Anal fissure: This is a tear in the lining of the anus and can cause rectal bleeding, especially during bowel movements. 3. Inflammatory bowel disease: Conditions such as Crohn s disease and ulcerative colitis can cause inflammation and ulceration in the digestive tract, leading to rectal bleeding. 4. Diverticulitis: This is a condition in which small pouches form in the lining of the colon and become inflamed or infected, leading to rectal bleeding and abdominal pain. 5. Colon cancer: While less common in younger individuals, colon cancer can cause rectal bleeding. Your brother s doctor may recommend further testing or referral to a specialist to help determine the underlying cause of his rectal bleeding. In the meantime, it s important for him to continue to take any prescribed medications as directed and to report any new or worsening symptoms to his doctor. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Diwashish Biswas, Internal Medicine Specialist