is the most common cause of rectal bleed under the age of 50. Painless bleeding is usually associated with a bowel movement. Bright red blood typically coats the stool at the end of defecation. Blood may also drip into the toilet or stain toilet paper. Hemorrhoidal
bleeding is almost always painless. Thus, bleeding associated with painful defecation should prompt investigation for other causes such as anorectal fissures.