I have blood in my stool, is it anal fissure or hemorrhoids? What is the difference between anal fissure and hemorrhoids

Anal fissure and hemorrhoids are two common diseases in the anorectal department. The symptoms of these two diseases are similar, and many people easily confuse them. So what is the difference between perianal disease and anal fissure?

Difference between anal fissure and hemorrhoids

Commonalities

Anal fissures are mostly accompanied by sentinel hemorrhoids, especially stage III anal fissures, which are accompanied by external hemorrhoids and internal hemorrhoids at the same time; while hemorrhoids can be internal hemorrhoids, external hemorrhoids, or mixed hemorrhoids. For the two types of anal fissure, in stage III, the appearance of the anus is mostly the same.

Differences

1. Anal fissures are mainly painful, while hemorrhoids are mainly bleeding. Hemorrhoids will only be extremely painful when external hemorrhoids become inflamed and swollen.

2. Anal fissures are cracks in the skin of the anal canal, but hemorrhoids are not. They can be confirmed during a digital rectal examination. Most people with anal fissures cannot undergo a digital rectal examination or a speculum examination.

3. Anal fissures are often accompanied by anal papillary hypertrophy and anal papilloma, while hemorrhoids are not accompanied by anal papillary hypertrophy or papilloma;

4. For patients with anal fissure, the anus appears narrow, while for patients with hemorrhoids, internal hemorrhoids often prolapse and turn outward.

Blood in stool

The blood in the stool caused by anal fissure is bright red and can be seen when dripping or wiping with toilet paper. Fresh anal fissures will cause severe anal pain after defecation. Hemorrhoids cause bleeding in the stool. The blood occurs during or after defecation. The blood is bright red and does not mix with the stool.

Perianal manifestations

Anal fissure is characterized by cracks in the anal canal skin, anal canal ulcers, and difficulty in healing. Anal fissures are cracks in the skin of the anal canal, but hemorrhoids are not. Hemorrhoids are caused by varicose veins, venous lumps, and sliding of the mucosa at the lower end of the rectum around the anus.

symptom

Anal fissure is mainly characterized by pain and bloody stool. Hemorrhoids are mainly characterized by bleeding, and only when external hemorrhoids become inflamed and swollen will hemorrhoids be extremely painful. In patients with anal fissure, the anus appears narrow, while in patients with hemorrhoids, internal hemorrhoids often prolapse and turn outward.

diagnosis

Anal fissure can be confirmed during digital rectal examination, but most people with anal fissure cannot undergo digital rectal examination or speculum examination due to the pain.

Concomitant diseases

Anal fissures are often accompanied by anal papillary hypertrophy and anal papilloma, while hemorrhoids are not accompanied by anal papillary hypertrophy or papilloma.