Namasthe Welcome to Healthcare-Magic Greetings of the day From your description of constipation and severe pain following it, i would consider the possibility of Fissure in anus. Its very common to have fissures especially when there are hard imapacted stools. I would suggest you the following which will address both te issues that is Constipation and fissure( Remember Constipation causes fissure and presence of fissure invites progression of constipation) 1. Drink plenty of water everyday: Consume 2 to 3 liter of water. It will help by mixing with the fiber of diet and give bulk to the stools so that they are well formed and soft. 2. High Fiber diet: Vegetable salad( 2 servings a day), Fruits especially citrus fruits. 3. Avoid Diet causing constipation: Especially those food stuffs containing refined flour like cakes, bread, biscuits, cookies 4. Hot Seitz bath: Add a handful of common table salt in a tub of lukewarm water and immerse the bottom by sitting in it. Every such session should last for 15 to 20 minutes. Two such session a day, one in the morning and one before retiring to bed at night. It would also be benificial to repeat it after every bowel movement. It will help in healing of fissure, decrease pain and relieve internal sphincter spasm. 5. Local application of local anesthetic ointment like Xylocaine will help in relief of pain. Apply it 15- 20 minutes prior to every bowel movements and also before retiring to bed. 6. Nifedepine Ointment: Local application of it will relieve the spasm of internal sphincter and help accelerate fissure healing. Almost all my patients have benefited from this by religiously following it and making it the part of their lifestyle especially water intake and high fiber diet. I hope the same will help you too. Do consult your physician if the symptoms persists or contact me. In case you need any further assistance, will be glad to assist you. Wishing you happy and healthy life Take Care Best Regards Dr T Shobha Deepak MBBS, MD Consultant Physician