I Have A Friend Who Has Been Having Extremely Painful

I have a friend who has been having extremely painful bowel movements and passing white skin-like objects with red dots. Her pain is so severe and after pushing so hard, her feces only comes out about the size of a baby adult finger. Due to the straining she now has hemeroids that bleed profusely. She just had an examine and there is no blockage in her bowel. What could it be?