Hi. Thanks for your query. Noted the history and understood your concerns. As per the history that you have provided about having discomfort passing stool along with the pain the most probable diagnosis is fissure in ano and not piles as the piles also called as hemorrhoids are painless unless obstructed or infected. I would advise you the following in such a situation: First of to get a confirmed diagnosis by a per-rectal digital examination, preferably by a General Surgeon and ano-proctoscopy to start with to know the exact cause. Colonoscopy at a later date by appointment and after proper bowel preparation to rule out any bigger problem. Sitz bath Laxative for smooth motions. Further medications as per your Surgeon s advise or surgery as needed and advised.