Hemorrhoids vs. Fissures: How to Tell the Difference

Hemorrhoids and anal fissures cause similar symptoms in the same area, so they are easy to confuse. Telling them apart matters, because the right care depends on knowing what you are dealing with. Here is a clear breakdown.

What Each One Is

A hemorrhoid is a swollen vein in the anus or lower rectum. An anal fissure is a small tear in the lining of the anus, usually from passing a hard or large stool.

How to Tell Them Apart

• Pain type: Fissures cause sharp, tearing pain during and after a bowel movement. Hemorrhoids tend to ache, itch, or throb.
• A lump: External hemorrhoids often form a noticeable lump. Fissures do not.
• Bleeding: Both can cause bright red blood, but fissure bleeding usually comes with that sharp, stinging pain.
• Itching: More common with hemorrhoids.

How Each Is Treated

The foundation is the same for both: more fiber, more water, and warm sitz baths to keep the area soft and soothed. Softer stools let a fissure heal and take pressure off swollen veins. Persistent fissures sometimes need prescription ointments.

When to See a Doctor

See a provider if bleeding is heavy or ongoing, pain is severe, or symptoms do not improve within a couple of weeks, so the cause can be confirmed.

This article is for general information and is not medical advice. Always consult a healthcare professional about your symptoms.