Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
Bright red blood on wiping after passing stool is most probably due to chronic
fissure in ano or hemorrhoids and your anal intercourse practice too can be the reason for such a problem.
Acid reflux is usually a
lifestyle disease meaning the stress, anxiety, irregular food habits and keeping away from natural course of life can cause such symptoms inspite of taking Prilosec and Tums.
This indicates a loose lower esophageal sphincter which needs a proper diagnosis, and medical or surgical management as per the findings.
Red wine and smoking all add to the symptoms that you have. Hence, I would advise you the following in such a situation:
-
Colonoscopy as you are 34 and your grand parent had
bowel cancer.
-Upper GI Endoscopy and Barium contrast studies may help further.
-CT scan of the abdomen, tests of stool and blood may help a lot in difficult to diagnose cases.
Please get these tests done to get a proper diagnosis and an appropriate management.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. T Chandrakant