Anal Fissure vs Hemorrhoids: Which One Do You Have?

Hemorrhoids and anal fissures are two common conditions that affect patients everywhere.

While they present with similar symptoms, the two are actually different in many ways.

Since they are both located in an area of the body that patients aren’t quick to want to openly discuss, the two conditions can become bothersome if they aren’t treated properly.

Hemorrhoids and fissures are often mistaken for one another when it comes to self-diagnosis.

That’s why it’s important to understand the difference between the two, especially if you want to avoid an extended bout with either. Here’s all you need to know about the conditions and how they are similar and different from one another.

Anal Fissure vs. Hemorrhoids

Hemorrhoids affect about 75% of the population by the time patients turn 50. They are also extremely common during pregnancy.

While they aren’t often dangerous, certain types of hemorrhoids can be seriously bothersome. Hemorrhoids are a cluster of swollen veins that affect the lower part of the rectum and anus.

Hemorrhoids can be separated into two types: internal and external. Internal hemorrhoids are located inside the anus and often go undetected. They are present in an area of the anus that is free from pain-sensing nerves, so the patients often report that they only symptom they experienced was painless bleeding.

In more severe cases, internal hemorrhoids may protrude out of the opening of the anus. These types of internal hemorrhoids may require more aggressive treatment.

External hemorrhoids are the one associated with the bothersome symptoms you might have heard about. External hemorrhoids form pillow-like lumps or clusters around the opening of the anus.

They are associated with itching, swelling, burning, bleeding, and pain.

Luckily, there are several over-the-counter products to help treat external hemorrhoids effectively.

Anal fissures are often mistaken for hemorrhoids, but they are different. Anal fissures are a split or tear in the mucosa that lines the anus. When this occurs, pain and bleeding often comes with bowel movements.

Because of the tear, anal fissures can be associated with sharp pain during a bowel movement. Some are visible while others require a rectal exam by a medical professional for proper diagnosis.

Difference Between Hemorrhoids and Fissures

Hemorrhoids and anal fissures are different for a number of reasons. First, they are completely different conditions. While a hemorrhoid is caused by swelling, anal fissures are caused by a rip or tear in the anus. The risk factors that lead to each of these conditions is also different. Hemorrhoids are most common in adults while anal fissures are most common in infants.

The two conditions are also diagnosed and treated differently. Hemorrhoids are rarely dangerous, but leaving an anal fissure untreated can lead to infection and a more severe illness.

It’s important to get checked by a medical professional if you can’t clearly tell whether you are dealing with an anal fissure or a hemorrhoid.

Proper diagnosis can ensure that your condition is treated effectively and you are on the road to recovery quickly.

Pictures of Hemorrhoids and Fissures

Many patients have a better understanding of the difference between hemorrhoids and anal fissures through a visual representation.

Let’s take a look at some graphics that provide examples of what both conditions would look like, where they are located in the rectum, and how you can tell which condition you have.

As you can see in the graphic above, hemorrhoids present themselves as a lump either inside the rectum or at the opening of the anus.

Anal fissures appear as a direct rip or tear at the opening of the anus. Here are some more examples of what the two conditions look like.

This graphic gives a closer view at what your anal fissure might look like.

This image closely represents the most common locations of internal and external hemorrhoids.

Finally, this image gives you a visual representation of the different stages of internal hemorrhoids and how they might present when they become prolapsed.

Hemorrhoids vs. Fissure

What causes these conditions?

Hemorrhoids have been commonly linked to the following causes:

• Chronic diarrhea or constipation
• Straining during bowel movements
• Sitting for long periods of time
• Obesity
• Pregnancy
• Poor diet

• Passing large or hard stool
• Straining during bowel movements
• Chronic constipation or diarrhea
• Childbirth
• Anal intercourse

Hemorrhoid vs. Fissure Pain

When it comes to symptoms, both hemorrhoids and anal fissures are associated with pain. Both conditions can cause pain during and after bowel movements. While pain is common with hemorrhoids, it is rarely severe.

The most commonly reported symptom of severe pain is generally only associated with strangulated or thrombosed hemorrhoids.

Anal fissures, on the other hand, are commonly associated with sharp pain in the anal area. This pain can be exaggerated during bowel movements.

Pain medications, such as Ibuprofen and Acetaminophen, can be an effective means of dealing with the pain of anal fissures.

Anus Fissure vs. Hemorrhoid Symptoms

The most common symptoms of hemorrhoids are:

• Painless bleeding during bowel movements
• Small amounts of blood in the toilet during bowel movements or on the toilet paper after wiping
• Pain
• Discomfort
• Itching
• Swelling around the anus
• A noticeable lump near the anus

• A visible tear in the skin around the anus
• A skin tag
• Sharp pain in the anal area, especially during bowel movements
• Blood during bowel movements
• Burning
• Itching