Many friends experience anal pain and symptoms such as bloody stool while using the restroom, but are troubled by not knowing whether it is anal fissure or hemorrhoids. Correctly distinguishing between anal fissures and hemorrhoids is of great significance for the prevention and treatment of diseases.
Experts from Zhengzhou Anorectal Hospital point out: The commonality between anal fissures and hemorrhoids is bloody stool; hemorrhoids and anal fissures are two different anorectal diseases. Bloody stool belongs to a symptom, and an anal fissure is a rupture of the anal canal skin below the dentate line forming a rhomboid fissure or ulcer. It is a common anal disease, more prevalent in males than females.
From a pathological perspective, the difference between anal fissures and hemorrhoids lies in that anal fissures mainly manifest as anal canal skin fissures, anal canal ulcers, and difficulty in healing.
Hemorrhoids, on the other hand, are formed due to the formation of varicose veins and venous vascular masses around the anus, as well as the sliding of the mucosa at the lower end of the rectum.
From a symptomatic perspective, the difference between anal fissures and hemorrhoids is that anal fissures are primarily characterized by pain. More than 80% of anal fissure patients exhibit pain, which can occur during defecation, after defecation, or when passing stool, presenting as persistent pain, sometimes akin to being cut by a knife, lasting for hours, making the patient restless. Anal fissures also cause bloody stools, but generally in small amounts, bright red in color, sometimes staining the toilet paper, or adhering to the surface of the feces, sometimes dripping blood, caused by defecation leading to pain, causing patients to be afraid to defecate, eventually possibly resulting in habitual constipation.
Hemorrhoids are primarily characterized by bleeding, with fresh red bloody stools; in later stages, the hemorrhoidal nucleus may prolapse outside the anus during or after defecation, accompanied by secretions, dampness, and itching around the anus, discomfort or feeling of fullness in the anus, usually without pain. However, if thrombosis, edema, inflammation, incarceration, or necrosis occurs, it can be accompanied by pain.
In cases of anal fissures, a fissure in the anal canal skin can be observed, whereas in cases of hemorrhoids, there is no such fissure. This can be determined through a digital rectal examination, although it may not be possible to perform a digital rectal examination or anoscopy in cases of anal fissures.
Anal fissures are often accompanied by hypertrophy of the anal papilla or anal papilloma, whereas hemorrhoids are not accompanied by hypertrophy of the anal papilla or papilloma;
Finally, experts from Zhengzhou Anorectal Hospital also point out: In cases of anal fissures, narrowing can be seen in the appearance of the anus, whereas in cases of hemorrhoids, internal hemorrhoids often prolapse and evert.