Hello, The typical cycle of constipation leading to hard stools leading to anal fissure and pain is very common. Your pain is during the passage of stool and after completing at least for 2-3 hours. You have been suffering from anal fissure which means a crack in the anal mucosa. It s very very painful condition. Prevent constipation by using laxatives like Looz or lactulose syrup before bedtime. Straining at defecation is to be avoided totally. Other factors that increase intra abdominal pressure like coughing are to be avoided. Tab. Senna chewable or dissolving films form can be used at bedtime for softening of stools. Anovate cream helps in reducing the pain and heals the fissure. It s very helpful. Please use it as prescribed. Sitz bath with warm water and betadine antiseptic would help relieve the pain and heal the ulcer. Diet must include more fiber like fruits, raw vegetables and plenty of water to soften the stool. Most of the times, anal fissure heals but reappears when stool is hard or constipated. Hence, try to avoid hard stools. Yet if all the above measures fail then you can go to a very minor surgical procedure after which you can be relieved of symptoms. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Pallavi M., Anesthesiologist