Confused about what’s going on with my anus fissure, fistula, or hemorrhoids?

I’m having some troubling symptoms and I’m not sure what’s really going on. I sometimes have soft but constipated stools, and passing stool can be difficult — almost like there’s a blockage inside. I notice tearing of the skin with dark or bright red blood in my stools, sometimes like melena.

There’s a white spot inside my anus, and sometimes pus comes out, especially after eating spicy foods, red chili powder, or drinking chilled liquids. I also feel tightness and a small pimple-like bump inside when I insert my finger, and it can come out when I strain. When I visited a surgeon, he said it was a fistula and mentioned I could do surgery even without an MRI. He said the tract had “come out this way” after inserting his finger. I felt some pain, but I wonder could this just be fissure pain? Could it also be internal hemorrhoids, or all three conditions at once?

I feel like I might be overthinking or imagining things, but I really want to understand what’s actually happening. Has anyone experienced similar symptoms? How did you figure out whether it was a fissure, fistula, or hemorrhoids?

Claud ai:- This looks consistent with a posterior anal fissure, which aligns with what the surgeon likely found. There's no obvious fistula tract opening visible externally.

https://photos.app.goo.gl/1CqBtoxDmEUPK5Gp9