A anal fissure and a hemorrhoids are different conditions. An anal fissure is a tear or tear in the anus. A hemorrhoid is when a vein in the anus becomes swollen. Both conditions can cause pain and bleeding. However, since they are treated differently, it is important to be able to tell them apart.
Learn about the differences between an anal fissure and a hemorrhoid, including how to diagnose and treat it.
Some common symptoms of an anal fissure and a hemorrhoid are blood on or in the stool and painful bowel movements. However, they can also cause other problems. It can be difficult to tell the difference between them from the symptoms, so diagnosis by a doctor is required.
The symptoms of an anal fissure can include:
- bleeding from the rectum
- pain during bowel movements
- Pain for hours after stool
- Discomfort or tenderness in the anal area
Symptoms of hemorrhoids can include:
- bleeding from the rectum
- Sensation as if something were in the anus
- itching in or around the anus
- Pain in or around the anus
- pain during bowel movements
- rectal pain
If the anus is damaged, it can lead to the development of a fissure. Some of the possible causes of a crack are:
Hemorrhoids share some causes with fissures, but there are other reasons why a hemorrhoid can develop. Some of the possible causes of a hemorrhoid can include:
- Heavy lifting, which may involve straining to pick something up
- Pregnancy, which can lead to overuse of the pelvic floor muscles
Anal fissures or hemorrhoids can be diagnosed in a number of ways.
First, a healthcare provider will take a medical history. They will ask about pain, bleeding, itching or burning, and other signs and symptoms, such as constipation or diarrhea. It can be helpful to chart these symptoms in the days or weeks leading up to an appointment with a doctor.
A physical examination is usually also performed. The doctor will want to look at the anal area.
You can do a digital rectal exam. This is when a gloved, lubricated finger is quickly inserted into the anus. A healthcare provider can feel if internal hemorrhoids are present. Blood or other fluids coming off the glove can also help with the diagnosis.
A anoscopy or proctoscopy is another test that could be performed. This uses a thin tool with a light on the end to look inside the anus and rectum. A biopsy, which is a small piece of tissue from the area, may also be taken and analyzed in the lab.
Before a physical exam or other test, you may want to ask about pain relief. Over-the-counter (OTC) oral pain relievers such as Tylenol (acetaminophen) or Advil/Motrin (ibuprofen) may help. There may also be local anesthetics that can be used in this area to relieve discomfort during an exam.
There are some treatments that are used for both an anal fissure and a hemorrhoid. However, others work for one but not the other, so it’s important to get a diagnosis and understand what the condition is.
A fissure can be treated through home remedies, lifestyle changes, OTC and prescription medications, and surgery.
At home, you can take a sitz bath (sit in warm water), eat more fiber, drink more water, and use a bidet after a bowel movement instead of wiping. Fiber supplements and stool softeners can also be used, but they should be started after a recommendation from a healthcare provider.
Prescription medications may contain nitroglycerin or pain-relieving creams that are applied directly to the anus. Oral medications may contain calcium channel blockers, which can be used after topical treatments have failed to provide relief.
For tears that become permanent and don’t improve with lifestyle changes, home remedies, or even medication, surgery could be the next step. A lateral internal sphincterotomy is the most commonly performed operation. It reduces tension on the internal anal sphincter, allowing for more blood flow and better healing.
Other options are a fissurectomy (removal of damaged skin around the fissure) or anal advancement flap surgery (a flap of tissue is used to cover the fissure area).
Hemorrhoids are most often treated with home remedies and by relieving anything that might be causing them, like constipation or diarrhea. For more severe hemorrhoids that don’t improve, prescription drugs and surgery can be done.
To reduce pain and other symptoms, witch hazel pads (like Tucks), barrier creams (like those containing zinc oxide), or creams containing phenylephrine (like Preparation H) can be used at home.
Most hemorrhoids improve with conservative treatments that can be used at home. However, some do not improve or become complicated.
Then procedures to reduce the size or remove the hemorrhoids can be used. These may include rubber band ligation (a rubber band is placed around the base of the hemorrhoid), sclerotherapy (a solution is injected into the hemorrhoid to shrink it), infrared photocoagulation (a light generates heat to shrink the hemorrhoid), or electrocoagulation (a Electric current tool is used to shrink the hemorrhoid).
Surgery can also be used for hemorrhoids that don’t respond to other treatments. The removal of a hemorrhoid is called a hemorrhoidectomywhich is performed while the person is sleeping under general anesthesia.
A stapled hemorrhoidopexy is another operation in which prolapsed hemorrhoids (those that stick out of the anus) are stapled in place.
Good care of the anal area is also important. For example, it can help to gently wipe or use a bidet after a bowel movement, avoid sitting on hard surfaces for too long, and use the toilet regularly.
Methods of preventing a fissure or hemorrhoid are similar in many ways, but there are a few differences.
To prevent a fissure, it is important to ensure that the stool is neither too hard (constipation), nor too soft or loose (diarrhea) and that it can be passed easily. In addition, it is important to get enough fiber in your diet and drink enough water to have regular bowel movements. You should also avoid straining when having a bowel movement.
Preventing constipation, diarrhea, and straining on the toilet is also important to prevent hemorrhoids. Sitting on the toilet for too long can be a risk factor for hemorrhoids, so it should be avoided.
Lifting heavy objects or lifting weights can contribute to the formation of hemorrhoids. It is important to learn how to lift heavy objects properly so as not to overexert yourself. For those who are vulnerable to hemorrhoids, check with a doctor for restrictions.
Some other risk factors for anal problems are pregnancy, age, and health conditions that cause constipation or diarrhea. For those at higher risk of fissures or hemorrhoids, it’s helpful to talk to a healthcare provider about how to avoid them in the first place.
While there are many similarities in the causes, treatment, and prevention of an anal fissure and hemorrhoid, there are some distinct differences. Both can show blood in the stool and rectal pain. Both can be caused by constipation or diarrhea. An anal fissure can also be caused by trauma, infection, or inflammatory bowel disease.
Getting a diagnosis and treatment plan from a healthcare provider is important for healing and preventing complications.
Conservative treatment at home can usually solve both problems, e.g. B. using a sitz bath and relieving constipation or diarrhea. Every condition has procedures or surgical techniques that can be used in cases that cannot be resolved with home treatment.
A word from Verywell
Fissures and hemorrhoids can be excruciating and embarrassing issues to deal with. Talking to a healthcare provider about anal bathroom issues can be difficult. Still, it’s important to remember that they will not be shocked or surprised.
Getting a diagnosis and the right treatment is important to help you feel better and prevent the problem from getting worse or coming back.
frequently asked Questions
When is it time to see a doctor about a hemorrhoid or fissure?
Sometimes a hemorrhoid or tear can get better with conservative treatments at home. However, if there is no change within a week or symptoms worsen, consult a doctor.
What’s the Best Way to Avoid Hemorrhoids?
Adding fiber to your diet, drinking enough water, and getting regular exercise can help prevent hemorrhoids. It’s also important to avoid spending too much time on the toilet. Reading or talking on the phone during a bowel movement can lead to spending too much time on the toilet.
Is rectal bleeding likely from hemorrhoids?
Blood in or on the stool or toilet paper can be from a hemorrhoid. However, it is important to know for sure. Bleeding can also occur for more serious reasons and it is better to rule them out.
A doctor can quickly diagnose a hemorrhoid, usually by a quick look at the anal area.