Concerned (Long post ahead)

Ok so this needs context first: My dad, and my grandfather, both have and had significant history with IBS and other bowel issues. I nyself never really experienced any problems until my mid 20s. I was about 220 lbs at the time, give or take, and I'm 6'2. I had a very fiber rich diet, ate healthy, was super active. In 2014 I started having random bouts of constipation. It was not that the stools were hard, quite the opposite. Almost looked like toothpaste tbh. Late in that year I started having pain and bleeding, which I chalked up to hemorrhoids from the random constipation. This went on, and got significantly worse, for about 2 years. I managed to get insurance and two doc trips revealed a perennial fistula. Had surgery around March of 2016, took about a year and a half to heal fully. No issues. I tell you that to tell you this:

Since 2023 there has been random bleeding. Not hemorrhoids, not at first. And no pain initially either. Just blood. My then-primary doc seemed to ignore any time I would bring it up. I had begun mental health meds around 2016, side effects made me insulin resistant. I gained over 100lbs in a year and neither doctor said anything until well after that point. And neither seemed to link the meds to the weight gain. But my primary started being...rude? Aggressive? About my weight at that point so idk. In any case, in the last year and a half I have been examined, scanned, and had a colonoscopy done with nothing being found outside of standard butt stuff.

This is not standard butt stuff. There seems to be some kinda open wound down there now, with drainage and bleeding regularly. As well as constipation.

Anyone here dealt with similar? I have changed all of my docs during this stuff and am otherwise much better, but I'm scared.