Hello I really appreciate your concern Thanks for consulting at health care magic. I have carefully worked through your case, and I can realize your health worries. Being your physician, I assure you not to worry as I will take care all of your medical concerns. from your above details he could possibly having habitual constipation or might be caused by faulty dietary habits, the complain will increase when you passes hard stool. to relieve constipation or hard stool, you should drink plenty of water, have food rich in fibers like green leafy vegetables, fruits, brown breads. Laxatives can help soften the stool. He should avoid constipation by taking laxatives or stool softening agents like lactulose or liquid paraffin in adequate doses 20 to 30 ml at bed time. Avoid prolonged sitting in one posture Say no to smoking and alcohol lower back pain can be related go constipation once you will get out of it, back pain will be alright, meanwhile you can take diclofenac tablet for pain relief. kindly consult a surgeon near you for the treatment of the condition. Hope it helps. If you need further, detailed and quick assistance related to any health issues in future, feel free to ask me a question directly from my profile. Have a wonderful time ahead. Regards!