had a sphincterotomy, still having a lot of trouble

Hello and welcome to e health forum.

From the description of the history, it seems that you have hard painful stools, associated with chronic constipation , which resulted in anal fissures.

Now, post the sphincterotomy, the scarring in the operated region might be causing the current difficulty in passing bowels.

The first step to manage this situation, to reduce your discomfort and pain is to treat your constipation and help to have soft stools.

To achieve this, here are some tips that might help you. They include

‎1. Eating more fruits, vegetables and grains, which are high in fiber‎

‎ Foods Rich in SOLUBLE Fiber: Oatmeal or oat bran; Brown rice; Orange, grapefruit, green plantain

‎ Foods that can act as laxatives: Prunes, figs, Psyllium husk, shredded wheat, flaxseed (oil), Senna, ‎Cascara sagrada, Aloe vera juice, Dandelion root, Molasses, Liquorice, etc. ‎

‎2. Drinking plenty of water and other liquids‎

‎3. Getting enough exercise, abdominal exercises are best to improve gut motility.‎

‎4. Taking time to have a bowel movement when you need to. Visit the toilet for 15 minutes in the ‎morning, even if you are unable to have a bowel movement. This relaxes and stimulates your digestive ‎system.‎

‎5. Relaxation and stress management techniques. ‎

‎6. Proper dietary habits, regular meals, not missing meals and breakfast,etc. Sit quietly for 15 minutes ‎after eating a meal to aid in digestion.‎

‎7. Cessation of smoking and tobacco use, excess dependence on sodas, colas and caffiene.‎

Trying the above tips should help to relieve your constipation. ‎

For the mean time, you can use Over the counter laxatives like milk of magnesia, to help relieve your ‎constipation. ‎

In addition, you can consult your surgeon, who can treat you for any surgery related complications that might be hindering proper bowel movements.

I hope this helps.