Q: I am a 26 years old male. I have been suffering from third degree haemorrhoids for the past 4 years. I consume isabgol everyday, to ensure a smooth bowel movement. If I eat less or take a controlled diet, I get constipation. This aggravates my problem. I have tried increasing the quantity of fruits and vegetable in my diet. But this hasn't provided me any relief. Eating excessive food has resulted in weight gain. I am not able to exercise as before. I was diagnosed with ankylosing spondylitis and a prolapsed disc about last year. Because of this, I had to stop weight training completely. Although I swim regularly, I also need to build some muscle mass to increase my metabolic rate. Please tell me a way to solve these problems.

A:I note that your problem is related to a combination of factors like haemorrhoids, constipation and excess weight. It is important for you to take care of your constipation, as it can lead to a worsening of piles. Besides increasing the amount of fibre in your diet, you also need to increase your daily intake of fluids. At times the constipation is related to an irritable bowel syndrome. In such a situation, you may need some motility agents. These can be prescribed by your gastroenterologist. You also need to undergo an examination called sigmoidoscopy. This will help to evaluate your problems further. You must try to lose the excess weight. If symptoms of piles persist, you may have to visit a surgeon as well.