Hi, Noted your typical history about having constipation followed by passage of hard stools as well as loose ones, going on for years, pain is severe like labor pain. My thoughts after reading your short history: There may be a primary problem with the anal fissure or so that cause constipation which in fact might have started as passing of hard stools causing the anal fissure, the vicious cycle. Once the hard part passed the remaining stool that comes might be normal or loose as you say. I would advise you the following in such a situation: Consult a General Surgeon or a Gastroenterologist for clinical evaluation, per-rectal examination, proctoscopy to start with, colonoscopy after preparation, the colon pressure studies and so on as needed. All these things will lead to a proper diagnosis and thus allow a proper management. If the anal fissure is present you may need a proper anal dilatation, correct of hard stools with stool softeners, laxative and so on. Once the primary cause if treated then the the stools may become soft and easily passable. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, General Surgeon