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What causes occasional bright red blood with or after some bowel movements.

Bright red blood off and on for several years with bowel movements. Various docs haven’t seemed concerned.  Recently Gastroenterologist did not see anything on initial visit with very short scope, just suggested sigmoidoscopy or colonoscopy. Medicare will not pay because I had a clean colonoscopy in 2013. Blood is always bright red and mostly happens with even a little straining. I have a lifetime of IBS (I am now 66).Nice smooth movements, no blood, but sometimes colon gets all out of sorts from diet, stools come out like big pile of mud, or almost diarrhea. Sometimes blood can be seen “on top” of this or no blood I can see but can go to urinate sometime later and when wiping front to back there will be what seems to me a lot of bright blood, kind of like it “pooled” there. And no, it is definitely not vaginal. I have recently had stool testing for parasites (negative) CT scan with contrast of abdomen (negative) blood work up, all good. There is no pain, but several years ago when this started I had a movement that felt like someone stabbing me with the point of something. Just that one time. A little itchy sometimes and some burn with the messier bowel movements.
Paying over $1,000 for colonoscopy will be a struggle
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3147776 tn?1549545810
I'm sure that's a bit alarming, but most of the time bright red blood (unless it's in large quantities) does not signal anything serious.  Here's an article that might help you identify potential causes: https://my.clevelandclinic.org/health/symptoms/14612-rectal-bleeding

Also, this article lists a test called Hemoccult, which may be cheaper than a colonoscopy.
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