Can I Have Hemorrhoids and fissures at the Same Time?

Causes of hemorrhoids

Have you ever suffered from hemorrhoids? Bleeding from the rectum sounds scary, but what if you could suffer from two similar conditions at the same time? Like hemorrhoids, anal fissures are an anorectal condition as well. Do you think a person can have hemorrhoids and fissures simultaneously?

We will get to that, but before we do, it's important to familiarize ourselves with these conditions. Let's learn what they are and how they can be cured.

Anal fissures

Anal fissures are painful cracks near the anal opening. They are caused by tears and laceration of the sensitive mucosal lining of the lower rectal cavity. Many research papers suggest that most anal fissures occur along the midline of the anus, and about 235,000 new cases are reported each year. Doctors also believe that anal fissures along the sides of the midline are linked to other diseases.

Fresh tears on the skin are caused by acute fissures, which can easily be dealt with. If acute fissures are left untreated, they develop into painful chronic fissures. Anal fissures are classified into posterior (back f the rectum) and anterior (front of the rectum) fissures. Manner of causation or etiology divides fissures into primary and secondary types.

The likelihood of fissures increases in individuals suffering from inflammatory bowel diseases like Crohn's disease. These diseases can irritate the sensitive lining of the rectal canal, thereby increasing the risk of tears. Hard, dry bowel movements and anal intercourse can also rupture the walls of the anus. The anal canal is less lubricated than the vaginal canal and is prone to trauma-induced rupturing.

Similarly, diarrhea and runny stool can irritate the rectal lining and cause fissures. It is worth mentioning that most of the symptoms are not direct causes but increase the likelihood of developing tears or lacerations.

A low fiber diet makes peristalsis, a movement that allows waste matter to pass along in the gut, difficult. A diet low in roughage also prevents the stool from retaining moisture; this causes strenuous bowel movements. Forced or strained bowel movement exerts increased pressure on the rectum, causing the skin to stretch and split.


Anal fissures are extremely painful, which makes identification easier. If you have a fissure, you will experience intense pain in your rectal cavity after a bowel movement. A unique characteristic is spasmodic pain in the anal sphincter. The pain can last for a few minutes or hours.

On rare occasions, fissures can also make a person unable to urinate or defecate. Since they are tears of the rectal lining, fissures can also bleed. Oftentimes, bright red blood can be observed in the stool. In people with a history of the condition, superficial cuts and deep lacerations of the skin are distinctly visible, along with scarred tissue.

A foul-smelling discharge can also be noticed in some cases, accompanied by extra-tissue growth around the anus.


Hemorrhoids or Piles are swollen lumps caused by the inflammation of the vessels inside the anus. They are the most common reason to visit a colorectal doctor.

There are three types of hemorrhoids. Internal hemorrhoids are formed on the inside of the anus. They usually don’t cause any symptoms. However, hemorrhoids on the inside are prone to prolapsing under severe circumstances. Medical attention is advised for such cases.

External hemorrhoids are formed on the outside of the anus. They can cause severe pain and discomfort. However, the symptoms can be managed at home. Both types of hemorrhoids can become thrombosed if blood clots inside the vessels.

Thrombosed hemorrhoids are extremely painful and prone to rupture. When the pressure inside the vessels increases beyond dangerous levels, they can rupture and cause the leakage of blood. Doctors advise medical treatment for thrombosed hemorrhoids since the pain is difficult to manage at home.

Hemorrhoids are caused by trauma or increased pressure and a combination of other factors like loss of muscular elasticity and the gradual weakening of the connective tissue of the anus. Based on these factors, there can be multiple causes of hemorrhoids.

Causes of hemorrhoids are similar to the causes of anal fissures since both conditions are linked to irritation of the rectum. Prolonged sitting on the toilet is the leading cause of increased intra-abdominal pressure. The pressure exerted on the rectum irritates already present hemorrhoids and aggravates symptoms.

Obesity and physical inactivity contribute to an increase in pressure, while anal intercourse causes trauma to the walls of the anus. Forced or strenuous bowel movements and dry stool are also known causes of hemorrhoids.

In anal fissures, constipation, diarrhea, and watery stool can also exert increased pressure on the lower rectum. These causes increase the likelihood of developing hemorrhoids. They also worsen the symptoms in already affected individuals.


Common symptoms of hemorrhoids include rectal bleeding and irritation of the anal region. They are also visible as bumps protruding from the anus. Swollen lumps that are blue or red in color also indicate hemorrhoidal disease. Painful scarring, boil-like skin tags of stretched skin, tears, and cracks signal the presence of hemorrhoids. Pockets of pus and fistulas are some complications that doctors observe in rare cases of hemorrhoids.

Can They Occur Together?

In conclusion, yes, hemorrhoids and fissures can occur at the same time. These conditions share many common causes, which can increase the risk of developing them simultaneously. Similarly, they can also occur separately. It all depends on the causes and the lifestyle choices of the concerned individual.

When they do occur together, it is confusing to distinguish between hemorrhoids and fissures as they cause similar symptoms like rectal bleeding, pain in the anal region, and itching or irritation of the anus.

Note: Self-diagnosis can be very harmful, and it is safer to consult a colorectal doctor for an accurate diagnosis of the condition.