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Random blood but no other symptoms

hello everyone

had my pouch for 11 years with minimal problems - a few fissures and IPS.

for the past month ive been getting blood when i empty the pouch maybe 1-2 times a week, it's probably more bright than dark red and sometimes an inbewtween medium colour.

i have no other symptoms whatsoever, no urgency or pain before going, in fact my pouch is functioning great and i generally feel well in myself. 

The amount of blood can vary from a bit in the stool and toilet paper and then to the toilet water turning red which is what i had this morning (it does seem to be worse in the mornings when the pouch is at its emptiest)

the strange thing is that the very next BM's i have after having the blood are completely fine no blood to be seen, for example this morning i had the blood and when i go to the toilet again when i get home from work the chances are there will be no blood, and the same for the next several BM's

The only thing that i changed in my routine that i can link it to is that i take Amitriptyline for IPS pains, and about a month ago i gave Nortriptyline a try to see if it was less sedating, it was but unfortunately it wasn't anywhere near as good as the Ami for the pain so switched back after a month, the blood started when i started the Nortriptyline so i dont know if this could have caised any irritation?

i should point out that i randomly became anemic last year but my surgeon couldnt find any source of bleeding after scopes and a CT scan so put it down to absorbtion issues stating that it can sometimes happen to us pouchies. I'm wondering if the bleeding now has got anything to do with that?

Yesterday i  regrettably cancelled an appointment i had made last week with my surgeon as over the weekend and Monday / Tuesday there was no blood so i thought it was disappearing, only to have the blood again this morning so i have re booked it for next week.

Naturally im worrying myself over this and what it could possibly be, i have read about cuffitis and pouchitis but dont display any of the additonal symptoms associated with them, so i'm wondering if it might be internal piles? Or an ulcer? Or would and ulcer give me other symptoms like urgency?

i'm hoping to get some insight into what it might be to tide me over until my appointment with my surgeon next week, in my 11 years of having the pouch i would get a bit of blood once every 4-5 months which my surgeon said is normal and that it can get irritated quite easily with certain foods. But no it's happening every week i know i should be trying to get to the route of it.

Thank you

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