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Discussion About Discomfort in the lower region of the anal walls

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Patient: Female, 56 years

The problem started 2 months ago after a particularly hard to pass stool. Pain started in the anus along with tenesmus like symptoms so much so that the patient found it hard to sit even on a cushioned surface.
With inconsistent medication over the two months (no painkillers) the pain however got significantly better and now only remains as a discomfort and a burning feeling.
There is no blood, no pain in the abdominal area or any apparent tear/scars.
There is: thinning of stool (shape), fatigue, lack of appetite, discomfort in the anus, anal walls seem inflamed, one side of the anal wall feels particularly tender when sitting in certain positions that put pressure on that side, and burning in the anal area.

Some prior diagnosis have been: hemorrhoids, anal fissure, and the most recent was infection.

In the most recent visit to the doctor, the physician suggested that the patient take medication (antibiotics, anti-inflammatory medication and laxatives) for two weeks howev

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