Bleeding hemorrhoids are common and occur with both internal and external cases. Be sure to consult a doctor if you notice any bleeding from the rectum before, during or after a bowel movement – and especially any bleeding in the absence of a bowel movement.

Internal hemorrhoids may cause bright red spots of blood may appear on toilet paper after a bowel movement. Blood spots may appear on toilet paper if one wipes the anus before a bowel movement, and, in addition, blood may also appear on individual pieces of stool. Because the bleeding takes place internally, small amounts of blood may leak from the anus even in the absence of a bowel movement and there is the possibility that the stool will pick up small amounts of blood on its way out of the large intestine.

Likewise, in external cases, because the swollen veins are on the outside of the anus, bright red blood streaks will tend to appear on toilet paper after a bowel movement. Blood spotting before a bowel movement would indicate that the patient is suffering from either internal hemorrhoids or both internal and external hemorrhoids, a rare but not impossible scenario.