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Hello this is Dr. Salama MD,
It is quite likely that his constipation has contributed to either hemorroids or an anal fissure.
If this is not addressed soon, he may start having blood in his stool due to the strain.
I would increase water and fiber intake with an over the counter fiber supplement in addition to stool softeners and laxatives.
He will also likely need to be seen by a gastroenterological specialist for an anoscopy and possibly colonoscopy.
Let me know if you have any other questions.
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