Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prevention
Frequently Asked Questions
Ananal fissureand ahemorrhoidare different conditions. An anal fissure is when there is a tear or a crack in the anus. A hemorrhoid is when a vein in the anus becomes swollen. Both conditions can cause pain and bleeding. However, because they’re treated differently, it’s important to be able to tell them apart.
Learn more about the differences between an anal fissure and a hemorrhoid, including how they are diagnosed and treated.
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Some symptoms in common of an anal fissure and a hemorrhoid include blood on or in the stool and pain while having abowel movement. However, they can cause other problems as well. Telling the difference between them based on symptoms might be difficult, so a diagnosis from a healthcare provider is needed.
The symptoms of an anal fissure can include:
Thesymptoms of hemorrhoidscan include:
When the anus is damaged, it can lead to the development of a fissure. Some of the potential causes of a fissure include:
Hemorrhoids have some causes in common with fissures, but there are also other reasons that a hemorrhoid can develop. Some of the potential causes of a hemorrhoid can include:
What Increases Your Risk of Hemorrhoids
Diagnosing an anal fissure or a hemorrhoid may be done in a few different ways.
First, a healthcare provider will take a medical history. They will ask about pain, bleeding, itching, or burning, as well as other signs and symptoms such as constipation or diarrhea. It may help to keep a record of these symptoms in the days or weeks leading up to an appointment with a healthcare provider.
A physical exam is usually also done. The healthcare provider will want to take a look at the anal area.
They may do adigital rectal exam. This is when a gloved, lubricated finger is quickly inserted into the anus. A healthcare provider can feel if there are any internal hemorrhoids. Also, if the glove comes away with blood or other fluid on it, that can help with the diagnosis.
Ananoscopyorproctoscopyis another test that might be done. This is when a thin tool with a light on the end is used to look inside the anus and rectum. A biopsy, which is a small piece of the tissue from the area, might also be taken and analyzed in the lab.
Before a physical exam or another 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 on the area to lessen the discomfort during an exam.
How Hemorrhoids Are Diagnosed
There are some treatments that will be used for both an anal fissure and a hemorrhoid. However, others will work for one but not the other, so getting a diagnosis and understanding which condition is present is important.
Fissure
A fissure might be treated throughhome remedies, lifestyle changes, OTC and prescription medications, and surgery.
At home, you can try asitz bath(sitting in warm water), eating more fiber, drinking more water, and using a bidet after a bowel movement instead of wiping. Fiber supplements and stool softeners might also be used, but they should be started after getting a recommendation from a healthcare provider.
Prescription medications can include nitroglycerin or pain relieving creams applied directly to the anus. Oral medications can include calcium channel blockers, which might be used after topical treatments haven’t provided relief.
For fissures that become long-term and aren’t getting better with lifestyle changes, home remedies, or even medications, surgery might be the next step. A lateral internalsphincterotomyis the most common surgery done. It reduces tension on the inner anal sphincter muscle, allowing more blood flow and better healing.
Other options include afissurectomy(removing damaged skin from around the fissure) or anal advancement flap surgery (a flap of tissue is used to cover the fissure area).
Hemorrhoids
To alleviate pain and other symptoms,witch hazel pads(such as Tucks), barrier creams (such as those that contain zinc oxide), orcreamscontaining phenylephrine (such as Preparation H) might be used at home.
Most hemorrhoids improve with conservative treatments that can be used at home.However, some do not improve, or they become complicated.
Procedures to reduce the size or remove the hemorrhoid might then be used. These can includerubber 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 creates heat to shrink the hemorrhoid), or electrocoagulation (a tool with an electric current is used to shrink the hemorrhoid).
Surgery might also be used for hemorrhoids that don’t respond to other treatments. Removal of a hemorrhoid is called ahemorrhoidectomy, which will be done while the person is sleeping under general anesthesia.
A stapledhemorrhoidopexyis another surgery whereprolapsed hemorrhoids(those that protrude from the anus) are stapled in place.
Comfort MeasuresTaking good care of the anal area is also important. For example, wiping gently or using a bidet after bowel movements, avoiding sitting for too long on hard surfaces, and going to the bathroom on a regular schedule may be helpful.
Comfort Measures
Taking good care of the anal area is also important. For example, wiping gently or using a bidet after bowel movements, avoiding sitting for too long on hard surfaces, and going to the bathroom on a regular schedule may be helpful.
Prevention methods for a fissure or a hemorrhoid are similar in many ways, but there are a few differences.
Preventing a fissure includes ensuring that stools are neither too hard (constipation) nor too soft or loose (diarrhea) and are easily passed. In addition, getting enough fiber in the diet and drinking enough water is important for having regular bowel movements. Straining to pass a bowel movement is also to be avoided.
Preventing constipation, diarrhea, and straining on the toilet is also important to preventing hemorrhoids. Sitting too long on the toilet can be a risk factor for hemorrhoids, so that should be avoided.
Lifting heavy objects or weight lifting can contribute to the formation of hemorrhoids. Learning to lift heavy objects properly is important so as not to strain. For those proneto hemorrhoids, check with a healthcare provider about any restrictions..
Risk FactorsSome other risk factors for problems in the anal area include pregnancy, age, and health conditions that cause constipation or diarrhea. For those at higher risk of a fissure or a hemorrhoid, talking to a healthcare provider about how to avoid them in the first place will be helpful.
Risk Factors
Some other risk factors for problems in the anal area include pregnancy, age, and health conditions that cause constipation or diarrhea. For those at higher risk of a fissure or a hemorrhoid, talking to a healthcare provider about how to avoid them in the first place will be helpful.
Summary
Getting a diagnosis and a treatment plan from a healthcare provider is important in healing and preventing complications.
Conservative at-home treatment can usually resolve either problem, such as using a sitz bath and relieving constipation or diarrhea. Each condition has procedures or surgical techniques that can be used in cases that do not resolve with at-home treatment.
A Word From Verywell
Fissures and hemorrhoids can be distressing and embarrassing problems to deal with. Talking about bathroom problems in the anal area with a healthcare provider can be difficult. Still, it’s important to remember that they won’t be shocked or surprised.
Getting a diagnosis and the right treatment is important to feeling better and not having the problem worsen or come back.
Frequently Asked QuestionsSometimes a hemorrhoid or a fissure may get better at home with conservative treatments. However, if there’s no change in a week, or if symptoms get worse, seek help from a healthcare provider.Learn MoreHome Remedies for HemorrhoidsAdding fiber to the diet, drinking enough water, and regular exercise may all help avoid hemorrhoids. Additionally, avoiding too much time on the toilet is important. Reading or using one’s phone while having a bowel movement can lead to spending too much time on the toilet.Learn MoreHow Long Do Hemorrhoids Last?Blood in or on the stool or the toilet paper can be from a hemorrhoid. However, it’s important to know for sure. Bleeding can also happen for more serious reasons and it’s better to rule those out.A healthcare provider may be able to diagnose a hemorrhoid quickly, usually through a brief look at the anal area.Learn MoreWhat Can Cause Rectal Bleeding?
Sometimes a hemorrhoid or a fissure may get better at home with conservative treatments. However, if there’s no change in a week, or if symptoms get worse, seek help from a healthcare provider.Learn MoreHome Remedies for Hemorrhoids
Sometimes a hemorrhoid or a fissure may get better at home with conservative treatments. However, if there’s no change in a week, or if symptoms get worse, seek help from a healthcare provider.
Learn MoreHome Remedies for Hemorrhoids
Adding fiber to the diet, drinking enough water, and regular exercise may all help avoid hemorrhoids. Additionally, avoiding too much time on the toilet is important. Reading or using one’s phone while having a bowel movement can lead to spending too much time on the toilet.Learn MoreHow Long Do Hemorrhoids Last?
Adding fiber to the diet, drinking enough water, and regular exercise may all help avoid hemorrhoids. Additionally, avoiding too much time on the toilet is important. Reading or using one’s phone while having a bowel movement can lead to spending too much time on the toilet.
Learn MoreHow Long Do Hemorrhoids Last?
Blood in or on the stool or the toilet paper can be from a hemorrhoid. However, it’s important to know for sure. Bleeding can also happen for more serious reasons and it’s better to rule those out.A healthcare provider may be able to diagnose a hemorrhoid quickly, usually through a brief look at the anal area.Learn MoreWhat Can Cause Rectal Bleeding?
Blood in or on the stool or the toilet paper can be from a hemorrhoid. However, it’s important to know for sure. Bleeding can also happen for more serious reasons and it’s better to rule those out.A healthcare provider may be able to diagnose a hemorrhoid quickly, usually through a brief look at the anal area.
Blood in or on the stool or the toilet paper can be from a hemorrhoid. However, it’s important to know for sure. Bleeding can also happen for more serious reasons and it’s better to rule those out.
A healthcare provider may be able to diagnose a hemorrhoid quickly, usually through a brief look at the anal area.
Learn MoreWhat Can Cause Rectal Bleeding?
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Health Service.Anal fissure.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.Jamshidi R.Anorectal complaints: hemorrhoids, fissures, abscesses, fistulae.Clin Colon Rectal Surg. 2018;31(2):117-120. doi:10.1055/s-0037-1609026Stewart DB Sr, Gaertner W, Glasgow S, Migaly J, Feingold D, Steele SR.Clinical practice guideline for the management of anal fissures.Dis Colon Rectum. 2017;60(1):7-14. doi:10.1097/DCR.0000000000000735Malaty HM, Sansgiry S, Artinyan A, Hou JK.Time trends, clinical characteristics, and risk factors of chronic anal fissure among a national cohort of patients with inflammatory bowel disease.Dig Dis Sci. 2016;61:861-864. doi:10.1007/s10620-015-3930-3Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: hemorrhoids, fissures, and fistulas.Ann Gastroenterology.2020;33(1):9-18. doi:10.20524/aog.2019.0438Wu S, Wang W, Chen H, Xiong W, Song X, Yu X.Perianal ulcerative skin tuberculosis: a case report.Medicine (Baltimore).2018;97(22):e10836. doi:10.1097/MD.0000000000010836Alvandipour M, Ala S, Khalvati M, Yazdanicharati J, Koulaeinejad N.Topical minoxidil versus topical diltiazem for chemical sphincterotomy of chronic anal fissure: a prospective, randomized, double-blind, clinical trial.World J Surg. 2018;42:2252-2258. doi:10.1007/s00268-017-4449-xBara BK, Mohanty SK, Behera SN, Sahoo AK, Swain SK.Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a randomized control trial.Cureus. 2021;13:e18363. doi:10.7759/cureus.18363National Institute of Diabetes and Digestive and Kidney Diseases.Hemorrhoid treatment.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Health Service.Anal fissure.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.Jamshidi R.Anorectal complaints: hemorrhoids, fissures, abscesses, fistulae.Clin Colon Rectal Surg. 2018;31(2):117-120. doi:10.1055/s-0037-1609026Stewart DB Sr, Gaertner W, Glasgow S, Migaly J, Feingold D, Steele SR.Clinical practice guideline for the management of anal fissures.Dis Colon Rectum. 2017;60(1):7-14. doi:10.1097/DCR.0000000000000735Malaty HM, Sansgiry S, Artinyan A, Hou JK.Time trends, clinical characteristics, and risk factors of chronic anal fissure among a national cohort of patients with inflammatory bowel disease.Dig Dis Sci. 2016;61:861-864. doi:10.1007/s10620-015-3930-3Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: hemorrhoids, fissures, and fistulas.Ann Gastroenterology.2020;33(1):9-18. doi:10.20524/aog.2019.0438Wu S, Wang W, Chen H, Xiong W, Song X, Yu X.Perianal ulcerative skin tuberculosis: a case report.Medicine (Baltimore).2018;97(22):e10836. doi:10.1097/MD.0000000000010836Alvandipour M, Ala S, Khalvati M, Yazdanicharati J, Koulaeinejad N.Topical minoxidil versus topical diltiazem for chemical sphincterotomy of chronic anal fissure: a prospective, randomized, double-blind, clinical trial.World J Surg. 2018;42:2252-2258. doi:10.1007/s00268-017-4449-xBara BK, Mohanty SK, Behera SN, Sahoo AK, Swain SK.Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a randomized control trial.Cureus. 2021;13:e18363. doi:10.7759/cureus.18363National Institute of Diabetes and Digestive and Kidney Diseases.Hemorrhoid treatment.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Health Service.Anal fissure.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.Jamshidi R.Anorectal complaints: hemorrhoids, fissures, abscesses, fistulae.Clin Colon Rectal Surg. 2018;31(2):117-120. doi:10.1055/s-0037-1609026Stewart DB Sr, Gaertner W, Glasgow S, Migaly J, Feingold D, Steele SR.Clinical practice guideline for the management of anal fissures.Dis Colon Rectum. 2017;60(1):7-14. doi:10.1097/DCR.0000000000000735Malaty HM, Sansgiry S, Artinyan A, Hou JK.Time trends, clinical characteristics, and risk factors of chronic anal fissure among a national cohort of patients with inflammatory bowel disease.Dig Dis Sci. 2016;61:861-864. doi:10.1007/s10620-015-3930-3Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: hemorrhoids, fissures, and fistulas.Ann Gastroenterology.2020;33(1):9-18. doi:10.20524/aog.2019.0438Wu S, Wang W, Chen H, Xiong W, Song X, Yu X.Perianal ulcerative skin tuberculosis: a case report.Medicine (Baltimore).2018;97(22):e10836. doi:10.1097/MD.0000000000010836Alvandipour M, Ala S, Khalvati M, Yazdanicharati J, Koulaeinejad N.Topical minoxidil versus topical diltiazem for chemical sphincterotomy of chronic anal fissure: a prospective, randomized, double-blind, clinical trial.World J Surg. 2018;42:2252-2258. doi:10.1007/s00268-017-4449-xBara BK, Mohanty SK, Behera SN, Sahoo AK, Swain SK.Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a randomized control trial.Cureus. 2021;13:e18363. doi:10.7759/cureus.18363National Institute of Diabetes and Digestive and Kidney Diseases.Hemorrhoid treatment.
National Health Service.Anal fissure.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of hemorrhoids.
Jamshidi R.Anorectal complaints: hemorrhoids, fissures, abscesses, fistulae.Clin Colon Rectal Surg. 2018;31(2):117-120. doi:10.1055/s-0037-1609026
Stewart DB Sr, Gaertner W, Glasgow S, Migaly J, Feingold D, Steele SR.Clinical practice guideline for the management of anal fissures.Dis Colon Rectum. 2017;60(1):7-14. doi:10.1097/DCR.0000000000000735
Malaty HM, Sansgiry S, Artinyan A, Hou JK.Time trends, clinical characteristics, and risk factors of chronic anal fissure among a national cohort of patients with inflammatory bowel disease.Dig Dis Sci. 2016;61:861-864. doi:10.1007/s10620-015-3930-3
Gardner IH, Siddharthan RV, Tsikitis VL.Benign anorectal disease: hemorrhoids, fissures, and fistulas.Ann Gastroenterology.2020;33(1):9-18. doi:10.20524/aog.2019.0438
Wu S, Wang W, Chen H, Xiong W, Song X, Yu X.Perianal ulcerative skin tuberculosis: a case report.Medicine (Baltimore).2018;97(22):e10836. doi:10.1097/MD.0000000000010836
Alvandipour M, Ala S, Khalvati M, Yazdanicharati J, Koulaeinejad N.Topical minoxidil versus topical diltiazem for chemical sphincterotomy of chronic anal fissure: a prospective, randomized, double-blind, clinical trial.World J Surg. 2018;42:2252-2258. doi:10.1007/s00268-017-4449-x
Bara BK, Mohanty SK, Behera SN, Sahoo AK, Swain SK.Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a randomized control trial.Cureus. 2021;13:e18363. doi:10.7759/cureus.18363
National Institute of Diabetes and Digestive and Kidney Diseases.Hemorrhoid treatment.
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