Need help! don't want to go back to the er cause they seem they didn't help. in pain and bleed from the anus, why?

Pain and bleeding: Rectal pain and bleeding is usually a fissure. Internal hemorrhoids usually bleed painlessly and external hemorrhoids usually hurt and don't bleed. If the fissure is chronic, present for more than a couple of months, the pain and bleeding may resolve but that does not mean the fissure is gone. Have an expert examine to confirm actual healing of the fissure once symptoms resolve.