Severe constipation for several years

Dear Ask The Doctor: I am having severe and extreme pain and burning everytime I go for a bowl movement,I also have alot of constipation with it,this has been going on for the past few years but it has gotten worse now,what can it be and what can I do?

Dear Max: There are various causes and treatments for constipation. In your case it seems that there may be an anal fissure contributing to the pain and subsequent constipation. Dietary modifications like increasing the amount of water and fibre in your diet are the first steps you need to make . This includes fresh green leafy vegetables, bulk forming foods like wheat etc. Also you can take bulk forming laxatives like methylcellulose, metamucil, bran etc, Some stool softeners that you can use are lactulose and colace. Sitz bath and anal creams like anusol will relieve pain during stool.