Pain in the anal region can be a total nightmare! No one wants to go around with that kind of pain or the urge to reach their rear region and scratch until the itch goes away - that doesn’t exactly scream poise and charm. Anal pain could be as a result of either - hemorrhoids vs anal fissures.
Confusion may sometimes arise in telling the two conditions apart so this article will explore what the difference is between them. You will also find out what treatment options you can try to find relief from the pain and discomfort.
Hemorrhoids vs anal fissures - What’s the Difference?
Knowing whether you have hemorrhoids or anal fissures will help you find the right treatment for your condition. A misdiagnosis and wrong treatment could leave you suffering from the same symptoms and never finding relief.
To differentiate between hemorrhoids and anal fissures, you will have to understand what each one of them is, what its symptoms are, and what its causes are.
What are They?
Hemorrhoids are swollen or distended veins in the rectum or anus. Hemorrhoids present in the anus are known as external hemorrhoids while those in the lower part of the rectum are internal hemorrhoids. Hemorrhoids are very common and by the time people are over 50 years, about 50% of them will have hemorrhoids.
Anal fissures, on the other hand, are tears or cuts on the mucosal lining of the anus which is very sensitive. An anal fissure is very painful which causes a muscle spasm and blood is not able to flow freely to the area so healing becomes difficult. Anal fissures are also common in the US with about 250,000 cases diagnosed annually.
Signs and Symptoms
You may have hemorrhoids for several years without realizing it until the symptoms show up. With anal fissures, you can tell when they first appear because they are extremely painful.
The signs and symptoms of hemorrhoids include:
- Anal itching
- Hard lump around the anus
- Pain during bowel movements
- Blood in the stool or on the tissue after wiping
- Painless rectal bleeding from internal hemorrhoids
The signs and symptoms of anal fissures include:
- Extreme pain during and after bowel movements
- Bright red blood in the toilet that‘s separate from the stool
What are Their Causes?
Hemorrhoids occur when a lot of pressure is placed upon the veins in the rectum and anus. This results in the hindrance of the smooth flow of blood between the area and the heart. Therefore, blood ends up pooling in these veins and they become swollen. The reasons why the anal and rectal veins may be under pressure include:
Straining in the Toilet
The veins in the anus and rectum are put under a lot of pressure when you struggle during bowel movements. If this happens repeatedly because of chronic constipation or diarrhea, blood pools in these veins and hemorrhoids are formed. Diarrhea and constipation make you sit in the toilet for too long so the veins in the anus and rectum are stretched out and they end up bulging and dilating. This also contributes to the development of hemorrhoids.
Obesity or Being Overweight
Having too much weight strains various body organs like the bones, back, and even blood vessels, especially on the lower part of the body. Consequently, blood vessels in the anus and rectum are put under so much pressure that they start swelling with blood. Therefore, obese and overweight people are more likely to get hemorrhoids than people who have a healthy weight.
There is a connective tissue between the rectum and the anus that gives support to their veins. As you age, this tissue gets weaker and when the slightest pressure is exerted on the veins, they swell. That is why hemorrhoids are so commonplace among people above the age of 50.
When pregnancy is at the third-trimester stage, the fetus gets very heavy and this puts pressure on the blood vessels in the lower regions of the body. This includes the veins in the anus and rectum. Hormonal imbalance in pregnancy also leads to the unusual swelling of blood vessels. Expectant mothers are, therefore, very likely to suffer from hemorrhoids. The good news is that these hemorrhoids disappear soon after giving birth.
Anal fissures occur due to trauma to the anal canal or anus. The trauma may be caused by having sphincter muscles that are way too tight so when you have chronic constipation or diarrhea, tears or fissures develop. The fissures may also develop because of prolonged sitting, inflammatory bowel disease, hard movements, anal intercourse, pregnancy, obesity, rectal surgery, anal infection, or colon malignancy.
Treatment Options of Anal Fissures
Increasing your fiber and fluids intake will soften your stool and promote the healing of an anal fissure. Soaking your anus in warm water for 15 to 20 minutes a couple of times a day will help soothe the pain, facilitate healing, and relax the sphincter muscles.
If these home remedies don’t work, a doctor may prescribe anesthetic creams to numb the pain and help with healing or medication to relax the anal sphincter muscle to also promote healing.
For chronic anal fissures, surgery may be performed to remove a small part of the anal sphincter muscle to reduce spasms and promote healing.
Treatment Options of Hemorrhoids
The discomfort, itchiness, pain, and bleeding of hemorrhoids can be reduced using home remedies such as soaking in a warm bath, cold compressing, applying aloe vera or witch hazel, increasing fiber and water intake, exercise, and avoiding straining in the toilet.
For large hemorrhoids that persist even after home remedies, surgical procedures are done to reduce their size.
Now that you can distinguish a hemorrhoid from a fissure, you can choose the appropriate treatment with the help of your doctor. This way, you can finally find relief from anal pain!