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Difference Between Hemorrhoids and Anal Fissures

A tear or fracture in the anus is known as an anal fissure. When a vein in the anus (swollen veins in your lower rectum) swells, it develops into a hemorrhoid. Both hemorrhoid and anal fissures can result in bleeding and pain.


Both hemorrhoids (piles) and anal (anal ulcers) cause pain, discomfort and bleeding


A hemorrhoid is when a vein in the anus (swollen veins in your lower rectum) becomes swollen. Symptoms include itchiness, swelling, constipation and blood in stool, pain in the rectum area.

Anal fissures

Anal fissure is also termed as anal ulcer. Anal fissures are tiny tears or cracks in the anus’s epithelium (a membranous tissue made up of cells that form various surfaces and linings throughout the body) that can be extremely painful. Constipation (hard stools), frequent diarrhea (loose watery stools), or straining during bowel motions are the main causes of anal fissures. They most frequently afflict people between the ages of 15 and 40 and are equally prevalent in both sexes.

Difference between Hemorrhoids and Anal fissures



Hemorrhoids or piles happen when there is intense pressure on the blood vessels and can occur internally within the anal opening or externally near anal area. Hemorrhoids are swollen veins in your lower rectum and anal area that results in pain, uneasiness and bleeding.

Anal fissures

These are cuts or tears near the anal area and are painful only during the bowel movement whereas hemorrhoids are swollen blood vessels.



  • Bleeding
  • Itching and pain
  • Prolapse
  • Lumps near anus that cause discomfort
  • Mucoid discharge

Anal fissures

  • Bleeding from the rectum
  • Frequent urination, urinary discomfort, or difficulty urinating
  • Stench-filled discharge
  • Itchiness or bleeding
  • The skin around the anus develops a visible crack
  • A deep burning pain while pooing



  • Child birth and chronic constipation
  • Heavy lifting, resulting in straining on the pelvic muscles

Anal fissures

  • Prolonged diarrhea
  • Scars in the anorectal area
  • Anal stretching and sex
  • Trying to insert any foreign objects into the anus
  • An underlying medical condition like Chlamydia, HIV, ulcerative colitis, inflammatory bowel disease, Crohn’s disease
  • Straining to poo, especially if the stool is hard, dry or large


The points of difference between Hemorrhoids and Anal Fissures have been summarized as below:


What does anal fissure look like?

An anal fissure that is more recent and acute looks sliced or recently torn. Most typically, a chronic or long-lasting anal fissure (hasn’t healed after eight to twelve weeks) has a deeper tear. Also, it could have fleshy growths (flesh-colored sacs beneath your skin filled with keratin) on the interior or exterior. A fissure is considered chronic (persisting for a long time) if it lasts for more than eight weeks.

How do you know if you have an anal fissure?

When you poop, anal fissures tend to cause strong discomfort, followed by severe burning agony that may last for several hours. When someone is bleeding when they urinate, they often see a small amount of bright red blood in their poop or toilet paper.

What does a fissure feel like?

It’s often described as feeling like walking through shattered glass. Anal fissure symptoms commonly include a tearing, ripping, or burning sensation, as well as typically a small amount of bright crimson bleeding during and after a bowel movement. The ailment is typically not serious, despite the fact that it may be highly uncomfortable.

What are the early stages of fissure?

In the early stages of anal fissures, you could feel a sharp discomfort when you urinate. A burning sensation that lasts for several hours typically follows this. People experience a small stain of bright red colored blood in their urine or excrement or on the toilet paper when they urinate or poop due to anal fissure. 

What can be mistaken for fissure?

Although fissures are relatively prevalent in the general population, they are frequently mistaken for other conditions that also cause discomfort and bleeding, like hemorrhoids.

Can I expect this fissure to heal on its own?

Similar to other minor skin tears or lesions, an anal fissure often resolves on its own within a few weeks. It is advisable to see a doctor if the anal fissure does not heal by itself within few weeks. The doctor may advise some medicines to expedite the healing of the fissure.

What happens if a fissure is left untreated?

If an anal fissure is left untreated, it causes imbalance in anal pressure causing obstruction of blood flowing in a usual way through the blood vessels enveloping the anus. Healing of the fissures is prevented by the reduced blood supply.

When should you worry about fissure?

If an anal fissure does not heal by itself even after 8 weeks, then it is a cause of concern. It could become a chronic fissure and would need immediate medical attention and treatment. 

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References :

[0]Ayantunde, A. A., & Debrah, S. A. (2006). Current concepts in anal fissures. World journal of surgery, 30, 2246-2260.

[1]Lohsiriwat, V. (2015). Treatment of hemorrhoids: A coloproctologist’s view. World Journal of Gastroenterology: WJG, 21(31), 9245.

[2]Sardinha, T. C., & Corman, M. L. (2002). Hemorrhoids. Surgical Clinics, 82(6), 1153-1167.

[3]Zaghiyan, K. N., & Fleshner, P. (2011). Anal fissure. Clinics in colon and rectal surgery, 24(01), 022-030.

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