Hi.. Welcome to HEALTHCARE MAGIC.. I have gone through your query and can understand your concerns.. As per your complain anal itching along with blood spots on tissue paper along with having a history of constipation.. It seems that the symptoms can be due to causes like either anal fissure or hemorrhoids.. I would suggest you to consult a Gastroenterologist and get evaluated and a thorough clinical evaluation and investigations like Anoscopy or Sigmoidoscopy can help in diagnosis and treatment can be planned accordingly.. In case of hemorrhoids you can be advised to apply steroid and numbing gels and do stiz bath that is sitting in warm water tub especially after bowels.. You should also take stool softeners and laxatives to ease in bowel movements.. In case of anal fissures you can be advised to apply calcium channel blockers like Diltizem containing ointment.. You can also do sitz bath, take stool softeners and laxatives.. Hope this information helps.. Thanks and regards. Dr.Honey Nandwani Arora..