Blood on toliet paper: Causes?

Patient : Hi, my name is TJ, I'm male, I weigh between 150-160lbs. And I'm 5'9 tall. Latly, after I take a poop and start wiping my butt, small spots of bright red blood will be on the toliet paper. It's not everytime either. And it's never a large amount of blood. It's very small amounts. And only when I wiping my butt. I don't know what this is, and I'm very worried. Sometimes I feel constipated, I don't know if that has anything to do with this, and I always drink 1-2 energy drinks to keep me going almost everyday. I dont know if that effects anything. I'm really worried about this, I am a smoker too, so the first thing that came to mind was cancer, even though my butt has nothing to do with my lungs. It doesn't hurt when I poop or anything, just small random spots of blood when I wipe. Sometimes I do push to get it out, and sometimes my poop, let's just say, seems to be to wide for such a small hole.... Sorry, I didn't know how else to say that. Please, please, please help me!
Doctor :   I can certainely understand your concern and worry. From the symptoms that you have mentioned it seems that you may be h aving some internal or external hemorrhoids or an anal fissure which is leading to the bleeding. Hemorrhoids are clusters of blood vessels which can either be present outside the rectal area or inside the rectum. Anal fissure is a tear in the normal mucosa ie the wall of the rectum and thus it leads to bleeding. Either way both these conditions occur when one has chronic constipation or hard stools. You can use some topical ointment or gel like anusol on this area . However long term treatment wise you need to drink more water during the day, increase the amount of fibre in your diet by increasing the intake of grains, fresh green vegetables etc. In case you are chronically constipated you could also take some over the counter meds like colace or metamucil which will help relieve the bowels. In case the bleeding continues or gets worse please see you family doctor. All the best.

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