Hi. Thanks for your query. Noted the history of long term pain in abdomen, rectal protrusion, bleeding per rectum after every bowel movement, very difficult to empty bowel movements, thin stools. All this history is suggestive that you might have one of the following: Thrombosed piles. Stricture. polyp or so. I would advise you the following: Consult a General Surgeon in your area, that is Whitefish Montana, or Kalispell Montana, you will get one easily - for clinical evaluation, per-rectal examination, proctoscopy to get started and colonoscopy with preparation. This will give the proper diagnosis and a plan for proper treatment.