Hi.. Welcome to HEALTHCARE MAGIC.. I have gone through your query and can understand your concerns.. As per your complain Anal fissures occurs due to a small cut or tear in the Anal Mucosa known as Anoderm and extend up the anal canal.. It is a very painful condition and the symptoms you are experiencing of heavy pain and bleeding during bowel evacuation seems to be due to it.. It can occur commonly in conditions like severe constipation and hard stools, anal intercourse, putting of anal scope or thermometer etc.. I would therefore suggest you to consult an Anorectal surgeon and get evaluated as the exact cause of the fissure needs to be ruled out and treated accordingly to prevent further increase in symptoms and treatment of cause can relieve.. He can advise you treatment that will relieve the underlying cause that is constipation as well as treat you to relieve the fissure.. -You can be advised to apply topical anaesthetics like Lignocaine gel.. -Calcium channel blocker containing ointments like Diltizem can be advised as it will dilate the blood vessels in the area and improve blood flow that will initiate healing.. -You can be advised to take stool softeners like Docusate and increase fibre intake that will also smoothen the stool like Psyllium and methylcellulose.. -You can also do Sitz bath by sitting in a tub of warm water 2 to 3 times a day especially after bowels.. You can also take painkillers like Ibuprofen if there is pain.. In case of no resolution surgical treatment can be advised.. Hope this information helps.. Thanks and regards. Dr.Honey Nandwani Arora.