 [ Symptoms ] most of my bowel movements are hard pebbles most of the time i use a rubber glove on my hand to get the stool out why i eat a lot of fiber and have used senocot and miralax without much relief i also have pain in my groin area that affects my walking sometimes i have been having this problem for a few years i also have gerd and take protonics for that what can i do [ Disease ] hi optimal treatment will be physical therapy + 6 month calcium and vit d supplement i know it may seem not convincing but you will be cured within 3 to 6 month i have personally treated many similar cases within 1 to 3 month with physical therapy notice that even after surgery you will need physical therapy pick a good physical therapist  good luck