### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi. I have been experiencing some lower abdominal pain (right side, sort of where the thigh meets the abdomen and moving over to the belly button) that I believed to be a pulled muscle. I have already had appendicitis about 16 years ago. I have difficulty with bowel movements from time to time. My doctor told me to eat more fiber . Now I have been noticing that there is bright red blood on the toilet paper, and obvious pain associated with my last 2-3 bowel movements. Do you know what could be wrong? Of note - my lower right side has not been problematic in about 2 days.

### output:

Hello,erinlynn0730,You mention having difficulty with bowel movements periodically. If you are constipated and have hard stool and strain during defication.it is possible to have hemorrhoids or fissure from which you can bleed. With fissure or tear in the lining of the very end of rectum, you get severe burning sensation. If you have internal hemorrhoids, they can prolapse or protrude after straining, and you could feel a lump. If you don't have these and are having bright red blood, you need to see a colorectal surgeon or a gastroenterologist to have endoscopy, either sigmoidoscopy or colonoscopy to rule out ulcerative colitis or bleeding polyps. If you have a family history of colon cancer, you need to have colonoscopy for sure. The other problem associated with right lower abdominal pain and bleeding is acute diverticulitis or bleeding from diverticulosis, pockets from the colon due to infection. Usually there may be fever, chills, bloody diarrhea and rightsized abdominal pain. Hope this gives you some idea for what to discuss with your own doctor. I wish you well.