What Is The Difference Between Hemorrhoids And Anal Fissures

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus. The swellings can protrude into the anal canal, interfering with bowel movements and causing pain. Three out of four American adults will likely experience hemorrhoids, making it a widespread condition.

Anal fissures are also located in and around the anus, but they are not swollen blood vessels. Rather, anal fissures are acute, fresh tears in and around the anus. 

Let’s learn more about the symptoms, treatment, and prevention of both conditions.

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How are they different?

While anal fissures are small tears in the tissues surrounding the anus, hemorrhoids stem from excessive internal pressure, causing veins to swell and bulge. 

Hemorrhoids are often caused by: 

  • Chronic diarrhea or constipation

  • Too much straining during a bowel movement

  • A low-fiber diet

  • Obesity

  • Sitting for prolonged periods

On the other hand, the cause of anal fissures is typically direct trauma to the region, such as from a difficult bowel movement. Inflammatory bowel disease or infection can also contribute to anal fissures developing. These cuts are usually acute, meaning they occur and resolve fairly quickly, although they can become chronic.


Despite their differences, hemorrhoids and anal fissures share some of the same symptoms.

The most common symptoms of hemorrhoids are: 

  • Painful or uncomfortable bowel movements

  • Intense itching

  • Blood in the stools (poop) or when wiping

In the case of prolapsed internal hemorrhoids, you may also feel a soft protrusion from the anus as the hemorrhoid has slipped out. Another symptom you may notice is tenesmus, the frequent and urgent feeling of needing to pass stool when you don’t.

A common symptom of anal fissures is a sharp and sudden pain during bowel movements. A deep burning sensation may follow, lasting up to a few hours.

Bleeding is also common when you have anal fissures. The small tears in the anal area can bleed, though generally only in small amounts. You may notice small amounts of fresh, red blood when you wipe or experience a stinging feeling around the open wound.

Chronic anal fissures last longer than six weeks. They’re often deeper cuts than the acute variety and may develop internal or external fleshy growths. In rare cases, anal fissures can result from cancer, HIV, or prior anal surgery.


Often, hemorrhoids and anal fissures are treatable with conservative non-surgical methods. However, in occasional cases, hemorrhoids or anal fissures may need surgery.

How to treat hemorrhoids 

The most suitable treatment for hemorrhoids varies based on your situation and the severity of the hemorrhoid. Treatments also differ if the hemorrhoids are internal or external. 

While external hemorrhoids often don’t require any specific treatment unless they become blocked with a blood clot or are painful, several treatments for internal hemorrhoids exist.

The first remedy you can use for hemorrhoids is a cream or ointment available from your doctor or local pharmacy or a suppository of medication mixed with a base of hydrogel or cocoa butter. 

Over-the-counter (OTC) hemorrhoid preparations may contain medications that reduce blood flow to the hemorrhoid. They may also act as lubricants, reducing the friction on a hemorrhoid caused by bowel movements.

Some doctors recommend that those with hemorrhoids use moist wipes instead of toilet paper after a bowel movement.

It’s essential to address the pain and itching from hemorrhoids. Not only are these symptoms uncomfortable, but scratching the area to relieve the itch may cause further damage. 

OTC medications like acetaminophen and ibuprofen may relieve pain, and you may be able to calm itching with a warm bath or a cotton pad soaked with witch hazel. Your doctor may also suggest a 1% hydrocortisone cream, but it’s important not to use hydrocortisone for more than a week as it can thin the skin.

More severe cases of hemorrhoids may need a different treatment, like a rubber band ligation. Your doctor can advise you on what treatment is best in your case.

How to treat anal fissures 

Treating anal fissures is usually a simple matter of allowing your body to heal. To facilitate the healing process, it’s a good idea to increase your fluid intake and consume more dietary fiber.

Dietary fiber and sufficient hydration will ensure your stools are soft, preventing excessive pressure on the fissure. This will allow your body to heal properly.

Home remedies to relieve symptoms

People often seek home remedies due to their ease of use and inexpensive nature.

One of the best home remedies for hemorrhoids and anal fissures is a sitz bath. This is a shallow bath of around three inches of warm water with half a cup of Epsom salts. A sitz bath can relieve inflammation and clean the area to relieve itching, promoting recovery from anal fissures and hemorrhoids.

Another option for treating hemorrhoids at home is applying a cold compress to the affected area, like an ice pack. If you use an ice pack, wrap it in a towel, as it should be cool to the touch, not freezing. Direct contact with your skin can cause ice burns.

You can also use a donut-shaped pillow to relieve pressure while sitting. This is suitable for both hemorrhoids and anal fissures. Pairing a high-fiber diet with increased water intake can reduce your risk of anal fissures or hemorrhoids.


In most cases, preventing anal fissures and hemorrhoids is as simple as not straining while passing stool. Plenty of water and dietary fiber can make it easier. 

Dietary fiber will give your stools substance, making them easier to pass, while sufficient hydration will ensure your stool is soft enough. When having a bowel movement, it is best not to force it and just let it happen. 

When to contact a doctor

If you are concerned about your bowel movements or are experiencing bleeding, pain, or itching, it may be a good idea to speak to your doctor. 

Your doctor can inspect the area, advise you on what condition you may have, and advise how best to remedy your situation. There is no substitute for professional medical advice, so if you need more clarification, talk to your doctor.

The lowdown

Anal fissures and hemorrhoids differ in their causes and treatment, although they overlap in some areas. If you are experiencing bloody stools, pain during a bowel movement, or notice blood when wiping, speak with your doctor. Both conditions can be significantly uncomfortable, but they are usually easy to treat.

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