Hi, The described complaints matches the clinical description of chronic anal fissure. Anal fissures are basically tear in the anal region, caused most commonly due to recurrent constipation, passage of hard stool and straining during defecation. Initially, the tear leads to fresh bright red bleed and discomfort/ burning while defecating. Later on, the bleed along with discomforts settles and the area heals. When such acute episodes occur recurrently the tear forms lump in the external area called as sentinel pile or anal tag. The problem requires surgical intervention as chronic anal fissures are difficult to treat and risks of abscess formation are high if left untreated. In meantime, you can follow the procedure of sitz bath twice a day and after defecating to ease discomfort. To follow the procedure, fill a bath tub with clean, warm water with addition of a few table spoons of epsom salt or up to 10 ml of betadine solution; fill the tub to enough to cover the bottom of your body and sit in the warm water for at least 10 minutes. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ayesha Shareef, General & Family Physician