u/Healthy_County8850

Hi all,

I recently moved to Ireland from India and I’ve been dealing with a recurring hemorrhoids issue since early February and would really appreciate some insight.

I was diagnosed with minor internal hemorrhoids by a GP. Initially, I had constipation and some bleeding, don’t if it due to weather or body is not getting adapted .Since then, I’ve significantly improved my routine:

•	Drinking 3–4L water daily

•	High-fiber diet (vegetables, fruits, dal, etc.)

•	Taking lactulose in 1st week and stopped and then again started  (started with 10 ml, now tapering)

•	Recently added psyllium husk (1 tsp at night)

•	Using suppositories (Scheriproct) for a short course

•	Cleaning with warm water after bowel movements (no dry wiping)

•	No significant pain, only occasional mild itching

Current issue:

•	My bowel movement is generally soft and easy to pass

•	BUT the very first part of the stool is slightly hard/dry and it’s kind of stuck 

•	That initial part seems to cause irritation → leading to a small smear of bright red blood on tissue

•	After that, the rest of the stool is soft and normal

Observations:

•	This pattern repeats daily

•	I feel like a small amount of stool might be sitting in the rectum for too long and drying out

•	I sometimes need slight pushing at the start, but not much

•	No dripping blood, only small smear

•	No significant pain

What I’m trying to understand:

1.	Why is the first part of stool still dry despite good hydration and fiber?

2. Has anyone experienced this “hard first stool” pattern and fixed it?

3. Would splitting lactulose dose or adjusting timing help?

4. Any strategies to ensure complete evacuation or prevent stool from drying overnight?

I’m trying to avoid overusing laxatives and want to fix the root cause rather than just manage symptoms.

Any practical advice or similar experiences would really help.🙏

Thanks in advance.