Q: Ever since my babies were born four years ago, I have been troubled with hemorrhoids. My problem is that in the past couple of months I have noted bleeding. My husband is pressuring me to go for a checkup. Is this necessary?

A: Hemorrhoids are varicose veins below the anal mucosa that can bulge through the sphincter and cause pain, itching, bleeding—and even lead to anemia. If all you have are hemorrhoids, you have several options. Various creams are available that will mollify the irritation and soreness of the hemorrhoids. Surgeries of various kinds—from placing elastic ligatures to dissection—have been performed. Very often, the problem is related to constipation. There are three extremely easy control measures for constipation.

First, consciously increase the intake of dietary fiber. This is readily accomplished by eating bran cereals, but a plentiful use of fruits, vegetables, and legumes usually accomplishes this first step. Second, there must be sufficient water to keep the fiber soft and bulky. The water requirement is higher in hot weather than in cold weather. Make sure that at least eight glasses of water are taken each day. The third step is the most important: Make time for a bowel movement. Many of us are so rushed and time-pressured that we neglect basic functions. Sit and wait until the bowel has an action. Do this regularly before your bathtime, and within a month you will be as regular as clockwork.

Now that’s all about hemorrhoids. But the reason I am answering this question is really not about getting you regular! The crux of the question here is that any type of rectal bleeding requires investigation.

It may be—and likely is—that your bleeding is related to your hemorrhoids. But bleeding can indicate many other potentially serious problems as well. These can range from polyps, colitis, to the much-feared cancer. No matter how frightening the thought, cancer can be beaten—especially if it is attacked early. The first step is to make a diagnosis. So I agree with your husband: Make that appointment. Today.

Sometimes hemorrhoids are made worse by other pathology in the bowel, so such a possibility is best excluded.

I did not discuss blood in the stool from higher in the gastrointestinal tract, where it may in passage through the bowel darken in color, and even give black stools. Nor did I talk about blood and mucus, etc. The bottom line (pardon the pun) is that any bleeding, of any color, requires investigation.

Now for those complacent ones reading this column: if you are over 50 years of age, have you had your colonoscopy? Let’s hop to it and go see the doctor.

Why take chances with God’s magnificent gift of life?