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I have been experiencing some very severe sharp pains in my rectum. He was discharged without passing any bowel. Anal fissure abdominal pain pain can be localized to the anus but can radiate to the buttocks, upper posterior thighs, or lower back. An anal fissure may extend into the ring of muscle that holds your anus closed internal anal sphinctermaking it more difficult for your anal fissure to heal. A rigid or flexible viewing tube is used to inspect inside the anus and rectum. Some children may find the sight of bright red blood in stools and toilet paper anal fissure abdominal pain. Anal fissure is the most common cause of severe anal pain and bleeding seen in the primary care setting, in urgent care and surgical clinics, and in Emergency Departments.