While colon cancer in a 34-year old is uncommon, it's still possible. So, I would go ahead with a lower endoscopy, either a flexible
sigmoidoscopy or
colonoscopy.
If the tests are negative, treatment for hemorrhoids, which statistically is the most likely cause, could be pursued. But I would do so only after endoscopy to exclude cancer.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin Pho, M.D.
KevinMD.com
Twitter.com/kevinmd