Your symptoms may be related to constipation with incomplete evacuation, excessive straining during stools, pelvic floor dysfunction, fissure/hemorrhoids, or sometimes muscle spasm in the lower back and pelvic region. Repeated straining can itself cause lower back pain, stiffness, bloating, and a constant feeling that stool is still left behind. I would advise: • Avoid excessive straining while passing stools • Increase water intake and fibre-rich diet • Regular physical activity/walking • Use a western toilet posture modification (footstool/squatting position) if possible • Avoid sitting continuously for long hours • Warm sitz baths may help if there is anal spasm or discomfort You may need evaluation for: • Chronic constipation • IBS (constipation predominant) • Pelvic floor dysfunction • Fissure/piles • Lower back muscle spasm or posture-related issues Tests that may be useful depending on examination: • Clinical examination including per rectal examination • X-ray/MRI lumbosacral spine if severe back symptoms persist • Ultrasound abdomen • Sometimes colon evaluation if symptoms are longstanding Please seek immediate medical attention if you develop: • Blood in stools • Severe abdominal pain • Fever • Weight loss • Weakness/numbness in legs or loss of bladder/bowel control A consultation would help identify the exact cause and guide treatment appropriately.