Hello and welcome to HCM, Persistent constipation despite use of stool softeners and other medication requires thorough investigations to rule out any other lesion of gastrointestinal tract (GIT). Constipation along with bleeding from the rectum suggests that there is bleeding from the rectum. Bleeding can occur due to trauma, polyps, vascular malformation, growth etc. A lower GI endoscopy- a colonoscopy needs to be done to look for any lesion in the rectum or colon. Management will depend on the type of lesion detected on colonoscopy. In case a polyp or growth is detected on colonoscopy, they have to be removed surgically and chemotherapy is required in case of malignancy. Thus, consult a gastroenterologist at the earliest for clinical assessment, relevant investigations like complete hemogram and colonoscopy and thus management. Thanks and take care Dr Shailja Puri