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Hemorrhoid Treatment Blog

Difference Between Anal Fissures & Hemorrhoids

What’s the difference between anal fissures and hemorrhoids?

At first it was something tiny. Almost nothing.

Maybe you felt just a twinge of pain or a tickle of an itch after going to the bathroom. Maybe you started to notice after a long weekend of playing hard that the water in the toilet was occasionally rosy. Maybe you just felt something back there when you were washing that was different.

Whatever it was then, it doesn’t really matter, because now it hurts. You’re seeing blood in the toilet or on the toilet paper, you’re experiencing itching, burning, and pain during and after a movement, and you’ve decided you’ve got to figure out what it is so you can make it stop. Yesterday.

If you’re experiencing one or more of these symptoms, you’re probably experiencing an anal fissure and/or hemorrhoids.

Telling the difference between anal fissure and hemorrhoids can be difficult, as most people have a hard time seeing, or are reluctant to look at the affected area. But knowing the difference between the two is important in choosing the right anal fissure or hemorrhoid treatment.

Anal Fissures

If you have anal fissure, chances are you’ll know it fairly soon after getting the condition. They hurt—usually fairly significantly. An anal fissure is a cut or a tear occurring around the anus. They are painful—really painful—because they occur in a kind of skin known as andoderm. Andoderm has no sweat glands or oil glands, but does contain an unusually high number of somatic sensory nerves—nerves that are especially sensitive to touch and pain. Anal fissures are caused by a trauma to the anus or anal canal, most often occurring because of large, hard movements. Many patients can remember the exact moment when the pain from anal fissure started. With anal fissures, you’ll often see some drops of bright red blood in the toilet water, separate from the stool. Effective treatments for anal fissures range from home remedies to prescription medications to surgery.


Hemorrhoids are often accompanied by fissures and show many of the same symptoms. . The difference between anal fissures and hemorrhoids is that they are each a different kind of injury. While an anal fissure is a tear of tissue, hemorrhoids are caused by the weakening of cushions of tissue in the lower rectum, causing the skin to blow up like a tiny balloon and fill with blood[A1] . There are two kinds of hemorrhoids – external hemorrhoids and internal hemorrhoids. Pain in the rectum is usually associated with external hemorrhoids and/or a fissure. You might also experience blood on the toilet paper after wiping, as well. In the case of internal hemorrhoids, the most common symptom is rectal bleeding. You might see bright red streaks of blood on the toilet paper or bright red blood in the water after passing a movement. You might also see streaks of blood on the stool. Hemorrhoid treatments range from creams and home remedies to hemorrhoid banding to surgery.

Ultimately, the difference between anal fissure and hemorrhoids, symptomatically, is difficult to differentiate for most persons experiencing one of these conditions. Anyone experiencing what they believe to be anal fissure or hemorrhoids should find a hemorrhoid doctor in their area. Specialists in this area are the best equipped to provide an accurate diagnosis and effective treatment for your condition, whatever it might be.

 [A1]This is only correct if you’re talking about thrombosed hemorrhoids.