Hi.. Welcome to HEALTHCARE MAGIC.. I have gone through your query and can understand your concerns.. As per your complain anal fissures occurs when there is tear in anal mucosa known as Anoderm leading to severe pain, discomfort in bowel evacuation and bleeding.. On the other hand piles or hemorrhoids occurs due to swelling and inflammation of the vein in anus or rectum leading to formation of painful lumps.. Treatment of both the conditions is different and a proper treatment can be instilled only after a confirmed diagnosis.. I would suggest you to consult a Proctologist and get evaluated and a thorough clinical evaluation and investigations like Anoscopy can help in diagnosis and treatment can be done accordingly.. In case of either fissures or piles, you need to take a high fibre diet to ease in bowel evacuation and drink plenty of water.. Avoid spicy food.. You can also take stool softeners like Docusate and laxatives like Polyethylene glycol.. In case of fissure you can be advised to apply ointment containing calcium channel blocker like Diltizem to improve blood flow in the area and improve healing.. You can also be advised to apply numbing gel to reduce the pain.. Take Ibuprofen to relieve pain.. Sitz bath or sitting in warm water tub can help.. In case of no resolution surgical treatment can be done.. In case of piles applying numbing and steroid gel can relieve.. In case if there is no resolution surgical treatments like rubber band ligation, sclerotherapy and cryotherapy can be done while Hemorrhoidectomy can also be advised.. Hope this information helps.. Thanks and regards. Dr.Honey Nandwani Arora.