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Difference Between Haemorrhoids and Fissure

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Fissures and haemorrhoids are the most common anorectal disorders and are often confused due to the similarities in their symptoms. However, there are distinct differences in the signs and symptoms, and they present differently in patients. These differences are explained below.

Haemorrhoids: Haemorrhoids (Haima = Blood, Rhoos = Flowing), also known as Piles (meaning a ball), are dilated, tortuous veins of the rectum and anal canal. There are two main types of haemorrhoids:

  • Internal haemorrhoids: Located inside the rectum, these are usually painless but can cause bleeding.
  • External haemorrhoids: Found outside the anal canal, these can be itchy, painful, and may bleed.


Here are some hemorrhoid causes include:

  • Constipation and straining
  • Inadequate water and fiber intake
  • Prolonged sitting on the toilet
  • Diarrhoea
  • Pregnancy, ascites


Here are some hemorrhoid symptoms include:

  • Swelling around the anal region.
  • Painless, bright red-colored bleeding during defecation.
  • Incomplete evacuation of bowels.
  • Itching and soiling of undergarments due to mucus discharge.

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Classification by Size:

  • 1st degree: Remain inside the rectum
  • 2nd degree: Prolapse through the rectum during defecation and reduce on their own
  • 3rd degree: Prolapse through the rectum during defecation and require manual reduction
  • 4th degree: Remain prolapsed persistently

Fissure-in-Ano: An anal fissure is a small tear in the lining of the anal canal. It is a very common and painful condition. There are two main types of fissures: acute and chronic.


  • Chronic constipation or diarrhoea
  • Passing hard stools
  • Patients with a tight anal sphincter
  • Normal vaginal delivery
  • Inflammatory conditions like Crohn’s disease


  • Sharp pain and a burning sensation during bowel movements
  • Bright red-colored blood along with the stool
  • Visible crack in the anal region
  • Itching or irritation in the anal region
  • A small lump or skin tag near the fissure

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