Question: A 21-year-old man with a 3-year history of hematochezia presented to the gastroenterology department with drop bright red blood after defecation, which was aggravated after eating spicy foods. He denied any history of hepatitis. On physical examination, the patient had an anemic appearance. Laboratory tests showed severe anemia (hemoglobin, 2.8 g/dL), but normal coagulation function, serum ammonia, and liver function. Colonoscopy showed internal hemorrhoids with no other abnormalities.