Q: I have a problem that I hear a lot of grumbling noise in my stomach and feel an itching sensation in the anus. I think it is piles but I am not sure. I have been suffering from constipation since some time. My motion is not normal. It is very sticky and feels as though I have not emptied my rectum. I am a married man and the situation gets worse when I have sex. The very next day of having sex, I can feel the grumbling noise more so and a lot of flatulence and indigestion problems occur. I cannot have sex continuously for two or more days because I feel very tired and then cannot sleep if I don't have sex daily. I don't suffer from insomnia. I look healthy otherwise. Is this a sexual disorder or is it a different disease? Please advise as I am not sure which doctor to visit or what kind of medication I should take?

A:You have mentioned several symptoms. The grumbling noise in your abdomen could be related to the foods you consume. Examples of these foods include beans and lentils or it may be a manifestation of an intestinal problem. The one that I am thinking about is the irritable bowel syndrome especially in view of the constipation and the feeling that you have not emptied your bowel completely. The fact that these symptoms are worsened after you have sex again speaks to a diagnosis of irritable bowel, since anxiety (that you may have about how you perform during sexual activity) tends to exacerbate the symptoms. The itching in the anal region could be due to haemorrhoids (piles). It could also be due to pin worm infestation. Having sex everyday is an unrealistic expectation even for someone as young as you. I feel that may be generating a lot of anxiety and therefore exacerbating your abdominal symptoms. I suggest you see a Gastroenterologist for further evaluation.