Thank for asking to HCM
This could be "Hemorrhoid" he should never exert the force at the time of defection fibber containing diet, drinking more water, beside this sitz bath and the intra rectum
application "Policresulen oint" would be helpful, if this dos not helps then clinical examination would be necessary, another possibility could be Protozoa intestinal infection and that could be simultaneous treated, with the drugs " Tab Metronidazole
400mg twice in day, Tab Dicyclomine
three times in day" hope this information helps you have nice day.