Hi,
I'm not sure, but when I wipe, I get to a part of the crack that feels like there's something blocking the smooth wiping, some lumps or bumps or something...I don't know. Is there a good chance that these are piles? And, if so, does it make sense that piles would themselves bleed? It seems like this area is the source of most of my bloody. I'm so confused...I hate this condition!

Hi, it might be skin tags and they're a nuisance to clean around. Try cleaning with moistened toilet paper gently if you can. I use a shower sprayer to clean the area and if I need any extra I moisten a cotton ball. If you lubricate the area a little before the BM it makes it easier to clean. I hate this condition too. Hope things improve soon Suzy.

Yes, those are probably piles (my doc said caused by fissures) making cleaning very hard. Best to use unscented babywipes (pat or push them up instead of "wiping") several times till it shows clean. Toilet paper is too dry and irritating.
Or, best, take a sitz bath with Epsom salts to ensure all is super clean. The piles make cleaning very hard not only because they are "in the way" with cracks and crevices, but because they can hurt like the devil. This cleansing takes diligence and patience. Sometimes after a BM and attempts to clean, I take a final babywipe and just shove it up in my crack and let it sit a bit while my bottom calms down. After about 15 minutes, go back to the bathroom and try again.
Good luck because this whole fissure/pile thing is horrific. Painful, itching AND very time-consuming to work toward healing.

First, in reference to the lumps and bumps, try to get a good look at the area with a mirror, if possible. Then, you can look at photos of hemorrhoids online to see if they basically match. Of course the best diagnosis would be one from a doctor.
Second - my doctor said that if there's bleeding, the source is generally INTERNAL hemorrhoids. He said that the majority of the external ones don't bleed (but of course there are exceptions.) Internal hems generally go unnoticed until the bleeding starts. They usually don't cause pain, and of course, you can't see or feel them.
And Third - I agree with BellaAyla posted above. She's right in that toilet tissue is extremely irritating to the anal area. Since developing piles and a fissure, my cleanup routine after a BM begins with unscented baby wipes. (ever so gently). I just keep using them until I'm satisfied the area is clean. Then, to be sure, I go into the shower to hose down the area using the handheld shower head. Gotta get into the nooks and crannies! By the way, my doctor told me to not use any soaps in the anal area.
The area is too tender & painful to dry with a towel, so my final step is drying the area with the blow dryer on low heat or the cool setting.
Hope this helps. Hang in there!