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General Surgery, Hemorrhoids » Is It a Hemorrhoid or Anal Fissure?

Is It a Hemorrhoid or Anal Fissure?

If you are experiencing painful passing of stool and noticing bright, red blood during your bowel movements, it is likely you have a hemorrhoid. Hemorrhoids are one of the most common reasons for a visit to a colorectal surgeon, like Dr. Alex Crean at MASJax. While hemorrhoids can be painful and irritating, the good news is they aren’t likely to cause long term damage. They can however be easily confused with anal fissures, cuts or tears in the lining of the anus. How can you tell the difference? With similar symptoms, it can be difficult for patients to determine what is going on. An exam by a trained colorectal physician will help you to get a clear diagnosis of your condition and find the best treatment for you, sooner rather than later.


Hemorrhoids are a common condition, affecting about three quarters of us the by age 50. Hemorrhoids are often associated with straining during bowel movements, commonly due to chronic constipation or diarrhea. Sitting for extended periods of time on the toilet also interferes with normal blood flow. This straining or interference in blood flow can cause blood to pool in the blood vessels, essentially creating a varicose vein in the anus. Hemorrhoids also commonly occur in pregnant women.

While some hemorrhoids are asymptomatic, hemorrhoid sufferers often experience anal pain, bleeding, itching, or notice a lump or protrusion from the anus. A hemorrhoid may also come with unpleasant anal leakage of stool or mucus. Hemorrhoid are typically a condition we want to treat soon to get patients back to a more comfortable everyday life, especially in the case where a hemorrhoid has developed a clot or become thrombosed. Treatment can range from topical ointment or in office treatment to outpatient surgery including a hemorrhoidectomy.

Anal Fissures

Anal fissures occur when there is a split or tear in the anus. This can occur from a particularly hard or large stool, and most patients can recall this occurring shortly before the onset of symptoms, maybe within a few days. An anal fissure can also be the result of some sort of trauma to the anus, including scratching. Fissures are somewhat common and usually patients recognize symptoms including severe pain and bleeding with bowel movements.

Anal fissures will be classified as acute or chronic, based on how long a patient has been experiencing symptoms and treatment varies accordingly. For some, anal fissures can be difficult to heal due to the active use of the anal sphincter causing frequent reopening of the wound. Luckily, treatments have been developed with this in mind, including temporarily paralyzing the muscle involved.


An experienced colorectal specialist like Dr. Crean knows that when patients come to see him, they are often in pain. You will start by discussing your symptoms and medical history and our team will evaluate any risk factors you may have that make one condition more likely than the other. Sometimes a determination can be made without an invasive exam, while other times a digital rectal exam will be needed.

Be Proactive

Most patients who have experienced either a hemorrhoid or anal fissure would recommend doing what you can to avoid them and are happy to take simple steps to avoid them reoccurring. One of these steps is incorporating fiber into the diet. This can be done through the food choices you make or with a daily fiber supplement. Healthy, high fiber diets add bulk to bowel movements, making them move more quickly through the intestine with less time to become too hard. Another easy adjustment: stay hydrated. Drinking water and maintaining good hydration will also aid your body in passing healthier stools. Along with the fiber in your diet, water is retained in the stool and will be easier to eliminate, when the time comes.

Next Steps

We encourage you to schedule an appointment with Dr. Crean if you are experiencing these uncomfortable symptoms. There is no need to be embarrassed or shy about your colorectal issues. Because symptoms of both of these conditions can be similar to other, more serious colorectal diseases, your doctor may want to have additional testing performed to rule out anything beyond what can be treated in the office. It is important to not ignore symptoms or suffer when you don’t have to.

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Memorial Advanced Surgery
3627 University Blvd S. Suite 700,
Jacksonville, FL 32216
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