Hi ! Good evening. i am Dr Shareef answering your query. From you history, it seems that you have developed a fissure in ano ( a cut in the perianal skin) due to passage of hard stool due to which there is pain over there and bleeding due to the ulcer. If I were your doctor, I would first examine the area clinically, and after confirming that it was a fissure, would go for some anti inflammatory drug along with a proton pump inhibitor, a broad spectrum antibiotic, and a stool softener like lactulose liquid at bed time. Add sitz bath to it (sitting on a luke warm water filled tub) three to four time a day for five minutes each. I am hopeful that you would get relief with this strategy, but I am afraid it would return if constipation (hard stool) occurs again for you. Therefore, to prevent the constipation, please avoid high protein diet, add a lot of roughage and fresh fruits along with sufficient liquids. Go for a regular exercise programme. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef