Hi. Thanks for your query. Noted the history and understood the concerns. Senna S is a laxative and is of a irritant character to cause loose stools. Since you already you have external hemorrhoids means you have to interno-external hemorrhoids which can bleed easily. Hence I would advise you the following in such a situation: Get an appointment of a General Surgeon for clinical evaluation, examination, per-rectal digital examination along with ano-proctoscopy and colonoscopy if you are more than 30 years of age to get a proper diagnosis and get a plan of management. Since the external hemorrhoids are present I am sure a proper surgery can help you to get the cure. Also have the following: Sitz bath in a tub with warm water. Laxatives to keep the stools soft. Normal full diet with high fiber content.