Constipation, fiber laxatives, anal sex, and straining are the primary preventable causes of enlarged hemorrhoids and anal fissures. Jim Goad's Personal Website. Publisher of ANSWER Me!, author of The Redneck Manifesto, Shit Magnet, and Jim Goad's Gigantic Book of Sex. Clinical Guidelines. Authored by a talented group of GI experts, the College is devoted to the development of new ACG guidelines on gastrointestinal and liver diseases.