Anal Fissure Versus Hemorrhoids


Bowel movements should not be painful. If you experience pain occasionally, then it’s pretty normal, but that should linger only for two to three days. If the pain remains for more days and you observe blood while passing stool, severe itchiness in the anal cavity, or problems in stool passing, then it’s quite serious.

If you are experiencing any of these symptoms, then most probably, you may have anal fissures or hemorrhoids.

The symptoms of both are pretty similar, which people often confuse. You can scroll through this article to know anal fissures versus hemorrhoids, which will help you take appropriate treatment.

What Is Anal Fissure?

If you are experiencing anal fissures, you will probably have tears in the anus lining or anus canal. This condition can occur to people of any age but is most prevalent in infants and middle age.

An anal fissure is painful because it occurs in a region with no sweat glands. There are a greater number of sensory nerves in this region which is quite painful to touch. If the tear worsens, the muscles near the anus become visible, known as the anal sphincter. 

The anal fissure is in the beginning stage if the tear in the anus lining occurs for 6 -7 weeks, But the condition is chronic if the anus lining has torn for more than seven weeks.

What Are The Possible Reasons For having Anal Fissure?

We are listing below a few possible reasons for having anal fissures.

  • Constipation for a long time
  • Inserting any foreign object into the anus
  • Anal sex
  • Putting strain during the bowel movement, especially when the stool is hard and large.
  • Diarrohea for a long time
  • Tightening of sphincter muscles
  • Strain while giving birth to a child.
  • Less blood supply in the anal area
  • Tuberculosis
  • Anal cancer

What Are The Signs And Symptoms Of Anal Fissure?

  • Pain in the anal area while passing stool
  • Severe constipation
  • Cracks or tears can be seen in the anal canal
  • Blood on stool
  • Blood on the toilet wipes
  • A smelly discharge from the anus
  • Hard to urinate
  • Severe itching near the anal area.

Treatment Of Anal Fissures

The main aim of anal fissures is to make bowel movements easier and more comfortable. The stool needs to be soft so you can easily release it; hence, there will be no blood from the anal area.

So you need to take stool softeners and drink lots of water to avoid constipation. There are various stool softeners available in the market. You can buy a good one to have good bowel movements and reduce pain.

Avoid drinking tea or coffee, as caffeine is not good for your body. It can lead to dehydration and other health issues. Additionally, you can increase the intake of fiber-rich foods like apples, avocados, strawberries, beans, broccoli, and many more to increase your gut health.

You can take a warm or sitz bath by soaking your anal area in lukewarm water for 10-15 minutes. Repeat this procedure many times a day for good results.

Another great alternative is cleaning the anal area gently and lubricating jelly to relieve pain. You should also avoid sitting for a longer time in the toilet as it can cause muscle straining.

If you practice the above methods, then it will reduce anal fissure symptoms by 90 percent.

But if the anal fissure again comes back after a few days or the above methods don’t work, then you need to use certain medicated creams over the anal area to reduce muscle spasms.

The doctor may recommend you for injecting Botox(Botulinum toxin injection) into the anal sphincter. It will help paralyze the anal muscles for a short period and gives you a lot of relief from pain.

But there are some side effects of taking this injection, like you may not be able to control your bowel and wind. But don’t worry about it, as these side effects will only last a short time.

But in rare cases, botox can spread to other body areas and weaken your muscles.

You may even experience difficulty in breathing. If you observe these two side effects, talk to your doctor instantly.

But if everything fails, then the doctor recommends surgery. Your surgeon may suggest a fistulectomy along with the botox injection. It is a procedure in which the surgeon cuts the injured skin from the anus.

He may even suggest sphincterotomy. It is a procedure that involves cutting the sphincter muscles so that your issues will heal within a short time. The surgery will be carried out first by giving you anesthesia.

The surgeon will make a small cut in the anal canal to reach the sphincter muscles(thin white muscles that circulate the anal canal). Your doctor will then try to stop the sphincter muscles from getting spasms by making a small cut that helps heal the fissure.

How Can I Prevent Anal Fissures From Occurring Again?

#1. Try To Eat food Rich In Fiber

If you have already dealt with the pain of anal fissures, then you should eat at least 25-35 grams of fiber-rich foods to prevent it from occurring again.

Some fiber-rich foods are wheat bran, peas, citrus fruits, nuts, and many more. But if your body is not getting enough fiber from the daily fruits and vegetables, then you try fiber supplements.

 You should also drink plenty of water and fiber-rich food or supplements to avoid bloating and gas issues.

#2. You Need to Stay Hydrated

Drinking a lot of water will help you to prevent constipation. But don’t drink alcohol or caffeinated drinks, as they can harm your body badly.

#3. Exercise

You should exercise at least 30 minutes daily to keep physically active. It even helps to keep your digestive system healthy.

#4. Don’t Ignore The Time Of Bowel Movement

If your body is telling you to have a bowel movement, you should go to the toilet immediately. If you delay it, it can make the stool hard and difficult to pass from the anus.

#5. You Must Practice Good Bowel Habits

Whenever you go to poo, then give enough time to pass stool. Don’t put a strain on the anus. But that does not mean you will sit in the bathroom for a prolonged time.

Keep your anal area clean and dry as much as possible, and avoid using fragrance soap. You should even use soft perfume-free toilet wipes to avoid anal fissures.

#6. Speak To Your Doctor About Laxatives

If you take a lot of fiber and still pass hard stool, you need to speak to your doctor about laxatives. These are medicines that will significantly help in preventing constipation.

#7. Frequent Diaper Change

If your baby has constipation, you should give enough water and frequent diaper changes to prevent anal fissures.

Ayurvedic Treatment For Curing Anal Fissures

#1. Jatyadi Oil

Applying jatyadi oil to the anal area helps in reducing burning and itching issues. Additionally, it helps to fix the tear caused near the anal area because of hard stool.

You need to take a soft cotton cloth, put a few drops of jatyadi oil over it, and apply it over the affected area. You need to use Jatyadi oil before and after passing stool and before bed. Applying 3-4 times over the anal region helps fix the anal fissures quickly.

But we will recommend you ask a doctor before using. Remember, excess use of this oil can cause fungus in your anal area.

Suppose the anal fissure is severe in your case. In that case, the doctor recommends using jatyadi oil on the anal area and a few medicines like Gandhak Rasayana or Rajat Bhasma. If you take Gandhak Rasayana, then it will help to reduce the swelling near the anal area and gives you relief from pain.

#2. Triphala Guggulu

You can take Triphala Guggulu for constipation issues. It will help in making the stool soft and cures anal fissure. But if you have mild constipation, then take Triphala Churna or Gulkand.

#3.Yashtimadhu Churna

Yashtimadhuchurna is also called mulethi; taking this can relieve pain in the anal region. It is an antacid and speeds up the recovery process.

What Are Hemorrhoids?

Hemorrhoids or piles are caused when the veins swell in the rectum’s interior or outside the anus. The swollen blood vessels or veins can sometimes get stretched during poop and cause extreme pain.

It is estimated that more than 50 percent of people above 50 years old are diagnosed with Hemorrhoids.

Types Of Hemorrhoids

Hemorrhoids can be of two types, i.e., external and internal.

#1. External Hemorrhoids

External hemorrhoids occur outside of the anus. If you find a big lump near the anal region, then it’s external hemorrhoid. Sometimes the condition worsens, and you may not be able to sit properly.

There are numerous sensing nerves in this region; hence, you experience pain along with swelling and itching near the anal area. If you don’t treat it earlier, you will have bleeding from the anal region.

External hemorrhoids can have a blood clot, which is otherwise known as thrombosed hemorrhoids. The lump will appear bluish or purple, and you will experience pain, severe itching, and bleeding.

#2. Internal Hemorrhoids

Internal hemorrhoids occur inside the anus or rectum. You cannot see the vein swelling, and they don’t cause much pain and discomfort because there are few sensing nerves. But you may experience blood on the stool or toilet wipes.

Internal hemorrhoids are classified into four types. We are listing them below.

  • Level One

If you have level one hemorrhoids, it will not cause much pain. You may or may not have bleeding from the anus. It even will not bulge from the anal opening.

  • Level Two

If you have level two hemorrhoids, the swelling will protrude while passing stool but will be pulled back afterward.

  • Level Three

In level three hemorrhoids, the swelling will protrude from the anal area and be pulled back when you push the bulge back into the anus.

  • Level Four

In level four hemorrhoids, the swelling protrudes from the anus permanently.

What Are The Causes Of Hemorrhoids?

  • The strain on anal or rectal veins while Pushing the stool out from your body.
  • Obesity
  • Pregnancy(growing of the uterus can sometimes put pressure on the anal veins)
  • Anal sex
  • Eating a diet which has less fiber content

Diagnosis of Hemorrhoids

Your doctor will first talk about your medical history and then physically and digitally diagnose.

  • Physical examination

During this examination, your doctor will look at your anal area thoroughly and check for any bumps, swelling, or infection near it.

  • Digital Rectal Exam

The doctor will wear gloves, put some lubrication and insert his fingers inside your anus to check for any lumps.

But for checking internal hemorrhoids, the doctor will do a more detailed test. We are discussing them below through specific points.

  • Anoscopy

The doctor will use a plastic tube-like structure called an anoscope to examine your anal canal.

  • Sigmoidoscopy

The doctor will use a tube-like structure called a sigmoidoscope to look into the lower part of the colon. He may even take some tissue to do specific other tests.

Treatment Of Hemorrhoids

#1. Home Remedies

You need to take food rich in fiber content to make the stool soft and easy to pass. Additionally, take a warm water bath or sitz bath 2 -3 times a day for at least 10 minutes.

It greatly helps in reducing pain near the anal area. Additionally, drink daily water to make the stool soft and easily move.

#2. Non Surgical Treatment

If the home remedies have not helped you get relief from hemorrhoids, you must apply certain creams and ointments on the anal area to relieve pain, itching, and swelling.

#3. Invasive Treatment

If your hemorrhoids are much more painful and you frequently have blood discharged while going to the bathroom, the doctor recommends invasive treatments.

We are listing a few treatments which your doctor can suggest, and they must be carried out only in the presence of your doctor. Remember this procedure is carried out without giving general anesthesia.

  • Rubber band ligation

The doctor will put one or two rubber bands around the base of hemorrhoid. It will help cut the blood supply to hemorrhoids, and as a result, the size of the lump will shrink within a few days.

Hemorrhoid will fall off within 7 -10 days. But the banding can be pretty uncomfortable for you after 3-4 days of the procedure.

Never try this procedure at home, as it can have adverse effects.

  • Injection or Sclerotherapy

The doctor will inject a chemical inside hemorrhoid to shrink it within a few days. But it will be less effective than rubber band ligation.

  • Coagulation(Infrared or Laser Techniques)

They are advanced techniques; laser or infrared heat can quickly shrink your hemorrhoid.

Surgical Procedures In Hemorrhoids

If you have applied ointments and creams or adopted all of the adobe methods and your hemorrhoids are still troubling, the doctor recommends surgery.

But very few percent of hemorrhoid patients require surgery. The doctor gives general or spinal anesthesia and carries out the surgical procedure.

Your doctor will recommend any one of the following surgical procedures.

#1. Hemorrhoid Removal

The doctor removes the excess tissue, which causes bleeding, and is carried out by giving you anesthesia.

There can be side effects after the procedure, like urinary tract infections or pain in the anal area. If you have pain in the anal area, take a sitz bath and dip your anus in lukewarm water for a few minutes daily to get relief.

These are temporary side effects and will go on within 6-7 days.

#2. Hemorrhoid Stapling

This procedure is less painful than the above. It is usually carried out when a patient has internal hemorrhoids, or a bump protruding and doesn’t shrink by nonsurgical procedures.

An instrument is inserted into the anus(where there will be no nerve endings), cuts the affected tissue, and then staple the tissue altogether.

The patient will return to normal life within a few days, and it has fewer side effects. But it has its downside, i.e., it will leave staples permanently inside the rectum.

How Can I Prevent Hemorrhoids?

  • Use fiber-rich foods or fiber supplements to soften your stool.
  • Drink a lot of water to avoid constipation
  • Go to the toilet as soon as you feel like going.
  • Do exercise for at least 30 minutes a day.
  • Maintain a healthy weight.
  • Don’t sit on the toilet for a long time.
  • Don’t put strain while passing bowel.

Ayurvedic Treatment For Curing Hemorrhoids

#1. Kshara Sutra

Your Ayurvedic doctor may recommend you for Kshara Sutra. In this method, the doctor uses a medicated thread and ties your hemorrhoid to the base level. Consequently, it will stop the blood supply; hemorrhoids will automatically fall within seven to eight days.

#2. Use Touch Me Not Plant Paste

The touch me not plant healing properties and helps to alleviate hemorrhoids pain as it is comprised of mimosine.

You can apply the touch me, not plant paste, on the affected portion to relieve burning and itching. There are even ready-made touch me not capsules available. You can even take them to reduce your anal pain and reduce swelling.

#3. Triphala

Triphala is a mixture of Amalaki, haritaki, and bhibhitaki. You can take Triphala to get relief from constipation.

Smooth bowel movement helps in alleviating pain from hemorrhoids.

#4. Guggul

Guggul is a herb that helps to eliminate poisonous substances from your body. It even helps in reducing the pain of hemorrhoids at a fast rate.

Anal Fissures versus Hemorrhoids

When the bowel movement becomes stiff, or you find it difficult to exit stool, anal fissures or hemorrhoids may occur.

 As discussed above, there are various similarities between them. So people often get confused and fail to diagnose. But we will suggest you always visit a doctor in such a case.

He will identify the real problem behind the bowel movement difficulty and prescribe medicine accordingly.

But in this article, we will tell you a few differences between hemorrhoids and anal fissures.

#1. Age

Fissures can occur in infants and people within the age gap of 20-40 years old. But hemorrhoids can occur when you get older, i.e., above 50 years old.

#2. Nature

An anal fissure occurs when a tear occurs in the anal canal, and a lump near the anus may accompany it.

Hemorrhoids occur when vein swelling occurs either in the interior of the rectum or the exterior of the anus.

#3. Pain

If you suffer from anal fissures, it will hurt you while passing bowel or sitting. But if we talk about internal hemorrhoids, it will not cause any pain. But external hemorrhoids can cause pain while passing stool.

#4. Symptoms

Muscle spasms can accompany you when you are diagnosed with anal fissures, but you will not have muscle spasms when you are diagnosed with hemorrhoids.

#5. Treatment

If you are diagnosed with hemorrhoids or anal fissures, the doctor will advise you for home remedies like eating fiber-rich food or drinking plenty of water.

But if such home remedies will not work, then in case of an anal fissure, the doctor gives a botox injection or sphincterotomy(surgical procedure).

If home remedies don’t work in hemorrhoids, the doctor uses rubber band ligation or sclerotherapy. But if you still don’t get relief from hemorrhoids, the doctor adopts a surgical procedure(Hemorrhoid Stapling or hemorrhoid removal).

#6. Prevention

Being overweight is the main reason for causing hemorrhoids, but weight gain is not a reason for causing anal fissures.


The best way to determine whether you have anal fissures or hemorrhoids is by consulting a doctor. Your doctor will visualize your anus, inspect it thoroughly, and detect whether you have anal fissures or hemorrhoids.

Sometimes there can be other problems in your body for which you will have difficulty in bowel movement or swelling near the anus. So an expert opinion is necessary to detect anal fissures or hemorrhoids.

The treatment will differ according to the conditions you are diagnosed with by your doctor.

There are even various ayurvedic medicines and therapy which helps to prevent both hemorrhoids and anal fissures. So you can consult a good Ayurvedic doctor to cure the disease.

Thank you for reading this article and if you have any queries, then ask us in the comment section. We will be happy to answer your queries regarding anal fissures or hemorrhoids.

About Dr. Ankurman Handique 45 Articles
A registered Ayurveda Practitioner. Loves to spread the knowledge of this Ancient Medical Science. He completed his degree BAMS(Bachelor of Ayurvedic Medicine and Surgery) from Govt. Ayurvedic College, Guwahati, Assam, India

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