Bleeding stool, anal pain and itching are considered to be caused by anal fissure, perianal abscess or hemorrhoids. If constipation causes dry stool, it will be particularly unpleasant due to lack of moisture drying, and the patient will force to defecate, and excessive force may lead to bleeding caused by tearing of perianal tissue. Stool stimulates the torn perianal muscle tissue, which will cause pain and itching symptoms. If a perianal abscess stimulates the perianal abscess tissue by stool friction during defecation, causing bleeding from abscess tissue damage, pain and itching will also occur. Hemorrhoids can also cause bleeding stools, anal pain and itching. If you have external hemorrhoids when you force to defecate, the hemorrhoids will stimulate the anus causing anal pain and itching, and the damage to the mucosal tissue of the hemorrhoids causes bleeding. If you have internal hemorrhoids, forceful defecation during dry stool causes bleeding caused by damage to the mucosal tissue of the hemorrhoid, and internal hemorrhoids cause anal pain and itching if they prolapse and irritate the anus.