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Most anal fissures are caused by stretching of the anal mucous membrane beyond its capability. An anal fissure is a small tear or crack in the lining of the anus. If you experience severe pain or bright red bleeding during or after bowel movements, you may have an anal fissure. Anal fissure (fissures) is a very painful condition caused by trauma to the anus and anal canal, which then cuts or tears the anus and anal canal tissue. These tears can be caused by straining to have a bowel movement, hard stools, and chronic episodes of diarrhea. Symptoms include rectal bleeding, anal itching, and painful bowel movements. Learn about which anal conditions are minor and those that are more serious. If your anal fissure is particularly severe or doesnt respond to treatment after 8 weeks, you may have to be referred to a colorectal surgeon, a doctor who specialises in conditions that affect the rectum and anus, for specialist treatment. Inflammatory bowel diseases like crohns disease and ulcerative colitis can cause complications to the tissue around the anus, like anal fissures. 1 an anal fissure is a split or tear at the end of the anal canal. A fissure that has been there for 3 months or more is chronic. A fully healed fissure can come back after a hard bowel movement or trauma. Medical problems such as inflammatory bowel disease (crohns disease), infections, or anal tumors can cause symptoms similar to anal fissures. If a fissure does not improve with treatment, it is important to be evaluated for other possible conditions.