** Thanks for contacting with your health concern 1. blood in the stool means there is bleeding somewhere in your digestive tract and as it is bright red [could be lower digestive tract problem], and also because an occult blood test was positive thus following is my observation: i. Digital examination, proctoscopy, colonoscopy, and sigmoidoscopy are important investigations in diagnosis of piles, fissure, or bleeding in colon ii. As occult test is positive thus common causes that are to be excluded are - Chronic duodenal or gastric ulcer - erosive gastritis [from painkillers, steroids] - variceal bleeding - carcinoma of the stomach - hookworm infestation - colorectal malignancy - mesenteric ischemia PS. To diagnose the site of blood loss [when occult blood is positive]: barium enema along with upper G.I. endoscopy is essential iii. USG or CT scan of the whole abdomen 2. In nutshell, a detailed history, meticulous clinical examination is essential to clinch the diagnosis.