An anal fissure is a small cut or tear in the lining of the anus. The crack in the skin causes severe pain and some bright red bleeding during and after bowel movements. At times, the fissure can be deep enough to expose the muscle tissue underneath. In most cases, the tear heals on its own within four to six weeks. Certain treatments can promote healing and help relieve discomfort, including stool softeners and topical pain relievers. Or your doctor may need to look for other underlying disorders that can cause anal fissures. An anal fissure most often occurs when passing large or hard stools. Chronic constipation or frequent diarrhea can also tear the skin around your anus.

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COMMON CAUSES OF ANAL PAIN
WHEN SHOULD I SEEK HELP FROM MY MEDICAL PROVIDER?
The anus is that part of the intestinal tract that passes through the muscular canal of the pelvis and anal sphincters. It is the final orifice through which stool passes out of the body. In adults, the anus is 4 to 5 centimeters long. The lower half of the anal canal has sensitive nerve endings. There are blood vessels under the lining, and in its mid portion there are numerous tiny, anal glands.
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A patient presents with severe anal pain, lasting hours after each bowel movement. She notices some intermittent bleeding with defecation. She comes to the office with the presumed diagnosis of hemorrhoids.
Anal pain can occur before, during, or after a bowel movement. It can range from a mild ache that can get worse over time to pain that is bad enough to restrict daily activities. Anal pain has many causes, most of which are common and treatable. However, if anal pain does not go away within 24 to 48 hours, it is important to see your physician. If fever is present with anal pain, a more urgent appointment is needed. This is a blood clot that forms in an outer hemorrhoid in the anal skin.