Anal fissures are small tears in the skin around the anus, while piles are swollen veins that can cause pain, itching, bleeding, or a soft lump outside the anus. The hanging skin may be a skin tag, which often develops after piles or fissures heal. In many people, fissures and early-stage piles can improve with medicines and healthy lifestyle changes. Treatment usually includes stool softeners, high-fibre foods, plenty of water, and warm sitz baths for 10 to 15 minutes several times a day. Doctors may prescribe pain-relieving creams and ointments that relax the anal muscles to help the fissures heal. Avoid straining during bowel movements, and do not sit on the toilet for long periods. If the fissures are deep or long-standing, or if the piles are large and protrude during bowel movements, medicines alone may not completely cure the problem. In such cases, procedures such as laser treatment, banding, or minor surgery may be advised. It is important to consult a general surgeon or colorectal specialist to confirm the diagnosis and decide on the best treatment for complete relief.

Bleeding from the anus can have several possible causes. The most common reason is haemorrhoids (piles). These are swollen blood vessels in the back passage (rectum) that may bleed during or after passing stools, especially if you have constipation or strain while using the toilet. Another common cause is an anal fissure, which is a small tear in the skin around the anus that can cause pain and bright red bleeding. In some cases, bleeding may occur due to infections, bowel inflammation, diarrhoea, or growths such as polyps. Less commonly, it may be related to serious conditions such as bowel disease or cancer. You should drink plenty of water, eat fibre-rich foods, and avoid straining. It is important to see a doctor if the bleeding continues, becomes heavy, or is associated with weight loss, weakness, abdominal pain, black stools, or a change in bowel habits.