It depends. If it’s been for years and is painless and there has been no change in the bowel motions recently, then it’s likely it’s the piles (or haemorrhoids in scientific jargon). However, if the bleed is a recent phenomenon, is associated with pain and change in bowel motion, then it may be an indication of a sinister cause such as a tumour. One should get in touch with a gastro physician or a Gastrosurgeon for complete assessment. Piles can nowadays be treated by minimally invasive technique such as laser or stapler technique that is almost painless and is wound free.