Fresh blood in the stool is usually caused by internal hemorrhoids. Bleeding from internal hemorrhoids can be seen on toilet paper, fresh blood in the toilet bowl, and sometimes severe bleeding can be spray-like. Based on the color of the blood, we can generally determine it to be internal hemorrhoids. When internal hemorrhoids are severe, anal lumps may protrude after defecation. If minor, the lumps can retract on their own; if severe, they need to be manually pushed back in, and if more severe, they remain irreducible at the anus. If you notice any of these symptoms, it is recommended that you visit the hospital's proctology department. A doctor can confirm whether the bleeding is caused by internal hemorrhoids through a digital rectal examination and an anoscopy, and then prescribe appropriate treatment.