If there is also dry stool and the dry stool rubs the mucous membrane of the hemorrhoid, it can lead to blood in the stool. There are often two diseases that may cause this condition to occur, one may be internal hemorrhoids and the other may be anal fissures. The characteristics of internal hemorrhoids blood in the stool, in addition to bleeding before stool, are bright red color, blood on toilet paper, often painless blood in the stool, fresh blood attached to the surface of the stool, and not mixed with the stool. The characteristics of anal fissure blood in stool, in addition to the above symptoms, include severe anal pain during defecation, anal pain still exists for a period of time after the stool, and the pain is relieved only afterwards. Patients with anal fissure often have a past history of dry stools and difficulty in defecation. Therefore, it is either internal hemorrhoids or anal fissures that cause patients to bleed first and then have a bowel movement.