Hi.. Thanks for contacting HCM for health query. Your boy friend is a healthy person who had blood in his motion four times over 2 years and you are worried about it. I understand the concern behind it. Do not worry. A minimal bleed in the stool while passing it tight can tear the soft mucosa and might cause bleed we have three small treatable issues (1) a small tear which heals of it (2) an anal fissure (3) pressured bulging of vein,the piles. Of course,rarely it could be a gastrointestinal pathology like inflammatory bowel disease. But always let us consider common things first. He is an active person with occasional bleed,so give him plenty of fibre rich food,include probiotic like yogurt in his diet and ask him to adapt a regular bowel clearance habit and things should settle. Hope our suggestions help. Take care.