Pain, Itching, and Bleeding: Is It a Hemorrhoid or an Anal Fissure?

Hemorrhoids and anal fissures are both relatively common, and they can both cause similar symptoms. But that’s pretty much where the similarities end. Each of these concerns occurs differently, and each requires different strategies for treatment and prevention.

At his practice in Deerfield Beach, Florida, Michael H. Tarlowe, MD, provides advanced, patient-centered care for both hemorrhoids and anal fissures. In this post, learn how these two conditions occur, what symptoms to look for, and how they’re treated.

Hemorrhoids and anal fissures: Why they happen

A hemorrhoid is a swollen vein located in the rectum (internal hemorrhoid) or around the anus (external hemorrhoid). Researchers don’t know exactly what causes symptomatic hemorrhoids, but they suspect they result from a combination of factors, like:

• Repeated straining during bowel movements
• Chronic constipation or diarrhea
• Eating a low-fiber diet
• Spending a lot of time standing or sitting
• Being overweight or obese
• Being pregnant

Hemorrhoids also tend to run in families.

An anal fissure is a small cut inside your anus. Like hemorrhoids, anal fissures often occur as a result of chronic constipation or from passing very large or hard stools. Some fissures may develop as a result of:

• Straining during vaginal birth
• Tight anal sphincter muscles
• Reduced circulation in the area
• Anal intercourse

Some underlying medical conditions, including inflammatory bowel disease and some sexually transmitted diseases can increase your risk of developing a fissure, as well. Fissures that don’t go away within two months are considered chronic.

Symptoms to look for

Anal fissures and hemorrhoids cause many of the same symptoms, including:

• Pain around the anus, especially during bowel movements
• Irritation, burning sensations, or itching around the anus
• Bleeding during a bowel movement

You might feel an external hemorrhoid or severe internal hemorrhoid if it extends beyond the anal opening, while fissures can cause a small mass of skin tissue to form near the anus.

Since the symptoms of these problems are so similar, the only real way to know which issue you’re experiencing is to schedule an office visit. Delaying care can lead to more severe symptoms and may increase your risk of a potential infection or other complications.

Although hemorrhoids and anal fissures produce similar symptoms, they happen in different ways and require different treatment. 

Hemorrhoid treatment

Dr. Tarlowe offers several treatment options for hemorrhoids, depending on whether your hemorrhoids are internal or external, along with other factors.

Rubber band ligation

Rubber band ligation is an in-office procedure that‘s used to treat severe internal hemorrhoids that bleed or bulge out beyond the anus when you have a bowel movement. In this treatment, Dr. Tarlowe places a medical rubber band around the base of the hemorrhoid. The band remains in place, blocking blood flow to the hemorrhoid until it falls off in about a week.

Sclerotherapy

Sclerotherapy uses an injection of special chemicals to treat internal hemorrhoids that bleed. Like rubber band ligation, sclerotherapy is performed in the office without anesthesia. Once injected into your hemorrhoid, the sclerosing solution causes the hemorrhoid to shrivel up and fall off within 7-10 days in most cases.

Hemorrhoidectomy

Hemorrhoidectomy is a minor surgical procedure performed under local anesthesia and sedation. During this procedure, Dr. Tarlowe surgically removes the hemorrhoid. Afterward, healing takes about 2-3 weeks.

Clot removal

Sometimes, an external hemorrhoid develops a painful clot. Dr. Tarlowe can remove the clot through a small incision. To be effective, clot removal needs to be performed within about three days from when your symptoms first occur.

Anal fissure treatment

After Dr. Tarlowe confirms you have a fissure, he recommends a treatment plan that typically includes one or more of the following:

• Lifestyle changes, like drinking more water and eating more fiber
• Over-the-counter stool-softening products
• Fiber supplements
• Prescription ointment
• Botox injections to reduce spasms that interfere with healing

When these approaches don’t work to heal your fissure, Dr. Tarlowe may recommend a procedure called a sphincterotomy to help the muscles relax, giving the fissure time to heal.

Don’t ignore your symptoms

Even though hemorrhoids and anal fissures typically aren’t serious, without prompt treatment, they can lead to severe complications. To learn what’s causing your symptoms and to find a treatment option that works, call 954-210-7127 or book an appointment online with Dr. Tarlowe today.