Hello! Welcome to HCM! Severe constipation can lead to hemorrhoids (known commonly as piles) that may be responsible for your bleeding. You need to address the problem carefully before it aggravates: 1) Most importantly you need to incorporate certain dietary changes: ensure adequate dietary fibre by include vegetables and wheat products in your diet. Try reducing the amount of refined carbohydrates. Ensure at least 1 serving of fruits like banana and guava daily 2) Ensure adequate water intake (thumb rule is at least 8 glasses of water 8 ounce each) 3) adequate sleep of 7-8 hours at night to regularize your bowel 4) You can include natural probiotics in diet in the form of 2 servings of curd/yogurt daily. Probiotic supplementation can also be used 5) Antibiotics are not recommended as they may alter your normal gut flora and even cause rebound diarrhoea 6) To reduce hemorrhoid associated bleeding you may take Dobesil 500mg capsule 1 cap twice daily for 5-7 days 7) Pan-D capsule 1 cap once daily at bed time to reduce acidity and improve bowel motion. This may be used daily upto a week 8) Carminative enzyme mixture 2tsp twice daily after meals to improve your digestion Note that long term use of laxatives is not recommended, As a stool softener Lactulose syrup once daily at bed time (15-30ml) occasionally when required. Take care Regards, Dr. Nirvik Sinha, General & Family Physician