Q. What is the reason for anal bleeding?

Hi doctor,

I am very much worried about my girlfriend, who is 31 years old now. She tends to bleed when she urinates and also when she goes for toilet. She is having this bleeding problem for about two to three years, usually on and off. Previously, she did not have a good diet, usually eats only one meal a day and it consists of fast food. She does not drink water or eat fruits as well. The bleeding can happen up to once a week or daily, if serious. Recently, we moved in together and I am trying to improve her diet. Now, she eats at least two to three proper meals a day consisting of nourishing soup, vegetables and meat. According to her, she bled only twice in the last three months.

However, today, she told me she is bleeding again after pooping and it was quite a lot. I am quite worried and hence decided to ask your help. She also told me that she did go to a specialist before and the specialist told her that there was a wound, probably due to constipation in the past. Also, she prescribed a cream and asked her to visit back after a month. She did apply and got it better, but unfortunately it was too expensive for her to go back to see the specialist. Can you tell me what is the reason for bleeding, as the wound should have healed since it has been a few years? Is this a totally new illness aside from the wound? Thank you.