I have pile and (or) fissure. Defacate.

I had piles for 2 years back and i took homeopathy medicine for it and it was fine. Just some months back a similar problem arrived with pain and itching. This time the doctor says it's fissure. For that i too medicine and felt fine. But the doctor also said that all my stools are not passing and the leftover gets soaked up dry in the anus and this is causing the pain at the start while defacating. The doctor has forced me to take hydrated fibre like fruits which I'm already doing since then. But it all still pains. However today i felt some tiny ball kind of thing. Now i think that i have piles again. Please help. I cannot understand what is the issue. Is it hard stools, pile or fissure... I dont know. It pains alot to defacate.