Hi there Dec1an...when we strain to pass motion it can cause piles [haemorrhoids]  they can be internal and external..this can cause blood on the paper or in the toilet bowl..keeping your bowel movements regular,  preventing constipation is important..as you have had the same issue for a couple of years you might want to think about your diet and intake of fluids ...when stools are hard and difficult to pass it can be due to lack of fluid in the diet...hopefully you have someone to share your concerns with and perhaps make an appt with your Doctor to put your kind at rest..

Hi there Dec1an...when we strain to pass motion it can cause piles [haemorrhoids]  they can be internal and external..this can cause blood on the paper or in the toilet bowl..keeping your bowel movements regular,  preventing constipation is important..as you have had the same issue for a couple of years you might want to think about your diet and intake of fluids ...when stools are hard and difficult to pass it can be due to lack of fluid in the diet...hopefully you have someone to share your concerns with and perhaps make an appt with your Doctor to put your kind at rest..