Hello, An anal fissure is a common cause of painful bowel. It produces bright red blood on the stool not mixed with it. Generally, it results from chronic constipation that is hard stool which cracks the mucosa (inner skin of the anal canal). The treatment is not difficult especially if it is not for a long time. Using stool softener like Ispaghula husk, increasing use of fibers and water all help to form a loose stool and to help cure the fissures. Applying nitrates cream locally in the area also help a lot in the healing of the fissure. If the very painful application of lignocaine gel to the area is very helpful in relieving the pain. On the other hand, hemorrhoids are the different problem that does cause blood with defecation but is most of the times painless. So, I wonder if you have both or confused one with other. We generally, avoid nitrates cream in hemorrhoids as it can worsen it. Though none of the two is a serious problem if you do not know exactly, the best option would be to see your doctor. He will examine you and decide whether it is fissure or hemorrhoids. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahboob Ur Rahman