A lot of people get confused between anal fissures and hemorrhoids.
These two disorders are misunderstood as the same intestinal disorder. It is because of similarities between the targeting locations and symptoms of both disorders.
Hemorrhoids and anal fissures mostly affect the lower portion of the large intestine. But it does not mean that these medical conditions are the same.
Anal fissures and hemorrhoids are two different medical conditions. Their causes and deep targeting location differ from each other. Further, they are also treated differently.
Keep reading to learn more about the difference between anal fissures and hemorrhoids.
What Is the Difference Between Anal Fissure And Hemorrhoids?
Anal fissures and hemorrhoids are two different medical conditions that vary prominently from each other. An anal fissure is simply a tear or cracks in the tissues present in the lining of the anus.
Hemorrhoids, on the other hand, are swelling of the vein and tissues surrounding that vein in the lower rectum or anus. It usually involves blowing up the skin, and that blown portion of skin is often filled with blood.
Unlike anal fissures, hemorrhoids are of two different types:
Internal hemorrhoids usually develop inside the rectum and do not cause pain. While external hemorrhoids are associated with the tissues surrounding the anus and always cause pain.
Similarity and Dissimilarity Between Causes of Fissure and Hemorrhoid
In some cases, hemorrhoids and anal fissures can result from the same causes. Let’s find out the risk factors and causes for both conditions and the reasons behind each disorder.
All the reasons that can lead to both hemorrhoids and anal fissures are given below:
Constipation: It is when stool becomes hard due to its incomplete elimination through the anus from the body. Lack of water and dietary fiber diet are primary reasons for constipation.
When stool becomes hard, it exerts pressure against the walls of the lower intestine. In chronic conditions, it can lead to damage to the walls and veins present in the rectum and anus. This further results in bleeding intestinal disorders, including hemorrhoids and anal fissures.
Diarrhea: It is a condition that involves frequent defecation, usually in liquid form. Putting pressure on lower intestinal tissues several times a day, as occur during diarrhea, can lead to hemorrhoids and anal fissures. Diarrhea can even worsen the existing hemorrhoids and anal fissures.
Anal Intercourse: Anal intercourse can result in both hemorrhoids and anal fissures.
Pregnancy: Carrying a child puts pressure on the tissues of the lower intestine. It can result in hemorrhoids and anal fissures during pregnancy. These conditions become more severe during delivery.
Intestinal tissues are also under increased pressure during a child’s exit from the body. It can result in chronic hemorrhoidal and fissure conditions. An anal fissure is mostly linked with tissue damage during childbirth or delivery.
Age is the key factor that differentiates hemorrhoids from anal fissures. Increasing age tends to increase the risk factors of hemorrhoids. Getting hemorrhoids is more common in older people.
On the other hand, anal fissures usually occur at a young age. A child can also develop anal fissures from pressure applied to the intestinal lining.
Some other factors can result in anal fissures, as mentioned below:
Sexually Transmitted Infections (STIs): Anal fissures can occur due to sexual contact. Infection from one person that is transmitted to other due to anal intercourse can damage tissues of the rectum.
Inflammatory bowel disease (IBD): The intestinal disorders causing the inflammation of the tissues usually cause damage to the anal lining. These diseases include Crohn’s disease and ulcerative colitis.
Human immunodeficiency virus (HIV) first attacks the body’s immune system. If kept untreated, it can lead to severe sexually transmitted diseases, known as AIDS, which can further proceed to anal fissures.
Tuberculosis: Anal tuberculosis, caused by Mycobacterium tuberculosis, can also lead to anal fissures.
Other Intestinal Injuries: Accidental and surgical cuts on intestinal tissues can be a reason for anal fissures.
Separately, the factors that can solely result in hemorrhoids include:
Heavy lifting puts pressure on the rectum or anus, resulting in hemorrhoids.
Obesity causes constricted blood vessels in the lower intestine due to increased pressure, leading to hemorrhoids.
How about Fissure and Hemorrhoid Symptoms?
Symptoms of hemorrhoids and anal fissures are quite similar. It is difficult to differentiate these disorders based on their symptoms.
For example, bleeding from the anus during bowel movement occurs during hemorrhoids and anal fissures. Pain can also occur in both anal fissures and external hemorrhoids. Internal hemorrhoids are not usually associated with pain.
In contrast to hemorrhoids, muscle spasms occur suddenly and uncontrollably in anal fissures. Prolapse of the anal canal is more likely to occur in patients with internal hemorrhoids.
Anal fissures have nothing to do with this kind of protrusion of anal tissues. Besides this, these medical conditions share many symptoms that are quite similar.
If a person suffering from an anal fissure, he can experience the following symptoms:
- Difficulty during bowel movement
- Blood in stools
- Pain during defecation
- Visible cracks on anal tissues
- Soreness or itching around the anus
- Anus-scarring tissue with a small lump
A person experiencing hemorrhoids can suffer from the following symptoms:
- Difficulty during bowel movement
- Blood in stools
- Pain during defecation
- Feeling as if there is something obstructed in the anus
- Unintentional passage of stools through the anus
- Soreness or itching around the anus
How To Diagnose Hemorrhoids And Anal Fissures Differently?
There are different ways to diagnose hemorrhoids and anal fissures. To diagnose other disorders, symptoms provide a helping hand by letting the doctor know what the problem is.
However, hemorrhoids and anal fissure symptoms can be confusing. Based on symptoms, doctors cannot differentiate between anal fissures and hemorrhoids.
To diagnose anal fissures, one simply needs to look for cracks and tears on the external surface of the anus. Various other techniques can be used to diagnose anal fissures if the doctor cannot view them from outside due to their different locations.
The following are the common methods to diagnose hemorrhoids and anal fissures:
Digital Rectal Daignosis
To examine your rectum, your doctor inserts a gloved, lubricated finger. The doctor will be able to feel any growths if they exist. A feeling of outgrowths on the lower intestinal tissues may indicate internal hemorrhoids.
Whenever blood comes out of the gloves, it indicates either damaged tissue or bleeding veins are present in the rectum or anus.
An anoscope, proctoscope, or sigmoidoscope can examine the large intestine’s lower portion.
These devices are inserted inside the anus and used to view the inner portion of the rectum.
A corresponding tube or device is inserted based on the patient’s age.
A sigmoidoscopy, anoscopy, or proctoscopy can only be performed on patients under 50. In most cases, doctors perform this test when digital examinations fail to detect the problem.
A colonoscopy involves a complete visual examination of the colon.
The doctor usually performs this test when they are unsure whether any other intestinal diseases are present. It also allows doctors to diagnose whether there colorectal cancer exists or not.
General Guide For Intestinal Diagnosis
Before a physical examination or other tests, ask the doctor about pain relief. Advil/Motrin (ibuprofen) and Tylenol (acetaminophen), which are sold over the counter (OTC), may be beneficial.
The area may also be anesthetized with topical anesthetics before the examination to minimize discomfort.
Treatment of Hemorrhoids And Anal Fissures Are Also Different!
Treatment of hemorrhoids and anal fissures can be the same or different. Home remedies are the same for relieving the symptoms of these medical disorders.
Following are some steps that patients should adopt at home to cure hemorrhoids and anal fissures:
- Take a diet rich in fiber. Dietary fibers promote better digestion and prevent constipation.
- Apply topical creams, ointments, and suppositories on the external portion of the anus.
- Soak the anal area in a warm bath for about fifteen minutes at least twice daily.
- You can take oral pain relievers such as acetaminophen (Tylenol), aspirin, or ibuprofen (Advil, Motrin IB, etc.).
Hemorrhoids can be treated in several ways, as discussed below:
Thrombectomy: It involves the removal of the blood clots formed in external hemorrhoids. This removal proves more efficient within two days of clot formation in external hemorrhoids.
Minimal invasive surgeries are small procedures that usually don’t require anesthesia. However, there are challenges after hemorrhoids surgery, certain recovery process to maintain including changes in daily habits and several do and don’t.
For example, during Band ligation, a small band is placed at the base of internal hemorrhoids to cut off the blood supply. Within a few days, that portion of the rectum falls off due to a lack of blood.
In the case of sclerotherapy, some sort of chemically active solution is injected toward hemorrhoidal tissues. Affected tissues shrink and fall off as a result of these chemicals.
Aside from that, internal hemorrhoids can be dried and diminished with laser or infrared light.
Hemorrhoidectomy: This surgical procedure removes the tissues or veins that cause bleeding and pain in the rectal area. It is considered the most effective method to cure chronic hemorrhoids.
Hemorrhoid Stapling: This surgery is most effective for internal hemorrhoids. It blocks the blood flow to the affected and swollen rectal tissues, further leading to shrinkage and fall of internal hemorrhoidal tissues.
Anal Fissures Treatment
The following methods can treat anal fissures:
Botox Injections: Botulinum toxin type A injections are applied to alleviate symptoms of anal fissure. By paralyzing the anal sphincter, muscular spasms are controlled through these injections.
Topical Creams: Lidocaine hydrochloride (Xylocaine) is an anesthetic cream that may relieve pain with anal fissures.
Nitroglycerin is usually applied externally to enhance blood flow to the anus. This allows the rapid healing of the effect anal tissues.
Surgery: Lateral internal sphincterotomy (LIS) is a surgical procedure done by doctors to treat chronic anal fissures. It involves the removal of the anal sphincter muscle and treating anal muscle spasms.
In addition, here you can read more about curing fissure permanently!
To summarize the difference between hemorrhoids and anal fissures, although both hemorrhoids and anal fissures affect the large intestine’s lower portion, they differ.
In an anal fissure, there are small cuts and tears in the anal tissue. Hemorrhoids involve the damage of rectal tissues and blood vessels.
Symptoms of both hemorrhoids and anal fissures are the same to some extent. While the medical treatments for both conditions can be similar, individual or very specific. Different surgeries for each condition can also be performed for a proper treatment and speedy recovery.