Hello I appreciate your concern Looking at your description that could be hemorrhoids or fissure in anus I would advise him to reduce your body weight if you are obese, you can do it with dietary restrictions and regular physical exercises chances of herpes is less likely. To be on safe side I would advise you to consult your doctor for per rectal examination and an proctoscopy or colonscopy if need be. Meanwhile try to avoid constipation by taking laxatives or stool softening agents like liquid paraffin or lactulose avoid prolong sitting in one posture. Lignocaine ointment for pain and burning sensation Pantoprazole or rabeprazole as an antiacidity medicines Have lots of fruits and vegetables with dietary fibers sitz bath will definitely help him and it can be related to liver disease as well if you can revert back to me with my answers, I will be able to help you in best possible way Hope this helps you wish you good health.