If you have ever dealt with discomfort in the rectal area, you are not alone. Hemorrhoids and anal fissures are two of the most common causes of anal pain, itching, and bleeding. Although the symptoms can seem similar at first, these conditions are very different in cause, appearance, and treatment.
Understanding the difference can help you get the right care, avoid unnecessary discomfort, and prevent the condition from worsening. Let’s break it down clearly.
What Are Hemorrhoids?
Hemorrhoids are swollen veins in the rectum or anus, similar to varicose veins. They are very common, with over half of adults experiencing them by the age of 50.
There are two types of hemorrhoids:
Internal Hemorrhoids
These form inside the rectum and are usually painless, though they can cause bright red bleeding during bowel movements.
External Hemorrhoids
These develop under the skin around the anus. They can cause itching, discomfort, and swelling. If a blood clot forms, it becomes a thrombosed hemorrhoid, which is painful and may feel like a hard lump.
What Is an Anal Fissure?
An anal fissure is a small tear in the lining of the anal canal. It is often compared to a paper cut and is caused by trauma to the area. Common causes include:
- Passing a hard or large stool
- Frequent diarrhea
- Straining during bowel movements
- Childbirth
Anal fissures often cause sharp, stabbing pain during and after bowel movements. You may also see bright red blood on the toilet paper or in the bowl. Because the tissue in the anal area receives limited blood flow and is exposed to constant friction, healing can take time, especially if constipation persists.
Key Differences Between Hemorrhoids and Anal Fissures
| Symptom or Factor | Hemorrhoids | Anal Fissures |
| Cause | Swollen veins from pressure | Tear in anal lining from trauma |
| Pain Level | Mild to moderate, sharp if thrombosed | Sharp, stabbing pain during or after BM |
| Bleeding | Bright red, often painless | Bright red, painful |
| Lump or Swelling | Common with external hemorrhoids | Uncommon |
| Itching or Irritation | Frequent | Less frequent |
| Healing Time | Varies with care and severity | Several weeks, especially if chronic |
| Treatment | Creams, sitz baths, and minor procedures | Ointments, softeners, hygiene, and possible surgery |
Causes: What Triggers Each Condition
While straining during bowel movements can lead to both conditions, the underlying causes differ slightly.
Causes of Hemorrhoids
Hemorrhoids usually result from increased pressure in the pelvic and rectal area. This may be caused by:
- Chronic constipation
- Pregnancy
- Sitting for extended periods, especially on the toilet
- Obesity
- Heavy lifting
- Low-fiber diet
Causes of Anal Fissures
Fissures are more commonly caused by direct trauma to the tissue. This may include:
- Passing hard or sharp stools
- Anal intercourse
- Inflammatory bowel disease
- Severe or frequent diarrhea
Diagnosis: How to Know Which One You Have
Many people try to self-diagnose based on symptoms alone, but because bleeding and pain can occur with both, it is easy to mistake one for the other.
A healthcare provider can usually identify the condition during a simple physical exam. In some cases, an anoscope may be used to view the inside of the rectum. This process is quick and helps determine the correct treatment.
There is no need to be embarrassed. Doctors treat these issues regularly, and the sooner you know what you are dealing with, the sooner you can find relief.
Treatment Options
Hemorrhoid Treatments
Most hemorrhoids can be treated at home. Options include:
- Over-the-counter creams with hydrocortisone
- Witch hazel pads
- Sitz baths to reduce inflammation
- Stool softeners and added fiber to prevent straining
For persistent or severe cases, outpatient procedures may be needed:
- Rubber band ligation
- Infrared coagulation
- Hemorrhoidectomy
Anal Fissure Treatments
The goal with fissures is to reduce strain and allow the tear to heal:
- Increased fiber and water intake
- Warm sitz baths several times a day
- Topical anesthetics or steroid creams
- Prescription ointments that improve blood flow
If the fissure does not heal within six to eight weeks, your doctor may recommend:
- Botox injections to relax the muscle
- Minor surgery called lateral internal sphincterotomy
When to See a Doctor
While some mild hemorrhoids and fissures can heal with home care, medical attention is recommended if:
- Pain or discomfort does not improve
- Bleeding is frequent or excessive
- You feel a lump or swelling near the anus
- Itching or drainage is persistent
- Over-the-counter treatments are not helping
- Symptoms return repeatedly
Delaying treatment can make the condition worse and more difficult to manage. A professional diagnosis and treatment plan will help you heal faster and more comfortably.
Get Real Relief at The Hemorrhoid Institute of Connecticut
You do not have to live with the discomfort, bleeding, or pain. If you are unsure whether you are dealing with hemorrhoids or a fissure, or if nothing you try is working, it is time to get expert help.
The Hemorrhoid Institute of Connecticut specializes in the diagnosis and treatment of both conditions. Our experienced team offers advanced, non-invasive, and surgical options tailored to your needs.Schedule your consultation today and take the first step toward lasting relief.
Visit www.hemorrhoidinstituteofct.com or call (203) 426-5554 to make your appointment.
