<s>[INST] Hello, my daughter just turned 13, a few times within past year she had had blood on her rectal area after bowl movement, just very small amount, I have assumed from difficult BM. Now she has had very large amount of blood on tissue, she says BM was normal and NO constipation...should I be concerned???? [/INST] Hello. I just read through your question. I agree that the most common cause for this symptom is constipation. Even when bowel movements happen without pain, this symptom can still occur. I recommend reviewing your daughters diet, making sure that she is eating fiber rich foods. The fiber will soften her bowel movements further, and hopefully alleviate the problem. If this does not work, I recommend consulting with your doctor, so the appropriate diagnosis can be made and the appropriate treatment plan implemented. </s>