See answer: It's true that constipation is most common cause of anal fissure, and also hemorrhoids, which are usually associated with painful bm, bright red blood on tissue paper or in toilet bowl, and "heaviness" in anorectal region. My concern is the chronicity of your constipation and, if you are not taking iron, black stools may imply bleeding from a source in upper GI tract. Recommend gastroenterologist.
Answered 8/30/2020
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