There are multiple reasons for blood in stools most important reason is haemorrhoids but there is wide variation based on the age of presentation when we see a patient who is younger in age like 20 to 25 most important cause what we find would be haemorrhoids or piles and recently there is an increase in a disease called inflammatory bowel disease in India which is otherwise divided into ulcerative colitis and Crohn's disease this is the other most important cause for bleeding stools in Eng patients but when you are seeing a patient who is more than 45 to 50 year old and he is presenting for the first time with blood in stools the first-hand mode for most important diagnosis should see a colon