Hi Thank you for asking HCM I have gone through your query. Fissures can give such symptoms. Fissures will be painful while doing digital examination also. A proper examination by general surgeon or proctologist usually can diagnose the problem. Proctoscopy is required in case of inconsistency in diagnosis. Treatment of fissures and piles are almost similar. Avoiding constipation is must in both cases. Take food containing high in dietary fiber. Taking dried prunes or prune juices at bed time is good. You can also take stool softeners like sorbitol or lactulose. Taking more plain water is also recommended. These all helps to relieve constipation. Sits bath is helpful for both piles and fissures. For fissures you can pour warm water on anal area before and after passing stools. This will help to relax the sphincter. applying diltiazem gel or glyceryl trinitrate (GTN) gel local is also helpful for healing of fissures. If these all not helping then approach your proctologist or General surgeon as surgical management will be needed. Hope this may help you. Let me know if anything not clear. Thanks.