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Signs and Symptoms of Anal Fissures Sharp pain while passing a bowel movement Burning or itching during bowel movements Radiating pain in the buttocks, upper thighs, or lower back Lingering anal pain after passing a bowel movement (up to several hours) Bright red bleeding in your stool or on toilet paper A visible tear in the skin of the anus A small lump near the fissure Anal muscle spasms Causes and Risk Factors of Anal Fissures Constipation Straining while passing a bowel movement Passing large, hard stools Chronic diarrhea Anal intercourse or penetration Childbirth Inflammatory bowel disease, such as Crohns disease Anal cancer HIV/AIDS Pregnancy Tuberculosis Obstructed defecation syndrome (a disorder that makes it difficult to pass bowel movements) Prior surgery in the area Sexually transmitted infections (STIs) Diaper rash Not eating enough fiber How Are Anal Fissures Diagnosed