On performing the per rectum (PR) examination, the following were noted:

• External Hemorrhoids: Clear, visible external hemorrhoids around the anal verge with mild protrusion, consistent with the patient’s report of bright red rectal bleeding after bowel movements.
• No Internal Hemorrhoids: No evidence of internal hemorrhoids detected upon palpation.
• Normal Anal Sphincter Tone: The anal sphincter tone was normal with no abnormal laxity or tightness.
• No Masses or Lesions: No palpable rectal masses, lesions, or signs of abnormal structures within the rectum.
• Cough and Squeeze Test: Both tests were negative, with no signs of peritoneal irritation or abnormal anal sphincter tone, suggesting no immediate concern for other rectal pathologies.

In general, if external hemorrhoids are the only finding and the bleeding is mild, further investigations may not be immediately necessary. However, due to the patient’s background and risk factors, it’s crucial to remain vigilant and consider further evaluation if the bleeding persists or worsens.