Difference Between Hemorrhoids & Anal Fissures

September 25th, 2024

06:04 PM

Bleeding during a bowel movement and anal discomfort are symptoms of two common and seemingly similar conditions: hemorrhoids and anal fissures.

It’s easy to confuse the two if you look at symptoms alone. Often, a medical exam is the only way to determine for sure if anal bleeding, irritation, and other issues are caused by anal fissures or hemorrhoids. Knowing the difference can determine what treatment will offer relief and what prevention strategies will help you avoid future problems.

USA Hemorrhoid Centers is an expert in non-surgical hemorrhoid treatment. This guide explains the difference between hemorrhoids and anal fissures and what to do if you think you have symptoms caused by one of these conditions.

Schedule A Hemorrhoid Consultation

What’s the Difference Between Hemorrhoids and Anal Fissures?

The difference between hemorrhoids and anal fissures is that hemorrhoids impact veins in or near the anus, and anal fissures are tears in the anal tissue.

Hemorrhoids are swollen veins in the anus or lower part of the rectum.

The veins in this region expand and widen as the tissue in the rectum and anus stretches and contracts to hold and eliminate stool. Excessive stretching of these blood vessels due to pressure and straining can weaken the vein walls, causing them to become swollen and inflamed.

Common causes of hemorrhoids include:

Straining during a bowel movement
Straining from heavy lifting
Excess weight
Pressure from a growing uterus during pregnancy

These swollen piles of veins can cause serious discomfort or bleeding. They can occur internally or externally.

Anal fissures are tiny cuts on the inner lining of the anus.

Like hemorrhoids, they can occur after straining from constipation or while passing a large or hard stool. Other possible causes include:

Tight sphincter muscles
Straining while giving birth
Anal intercourse
Chronic diarrhea

Hemorrhoid Symptoms vs. Anal Fissure Symptoms

Some hemorrhoid symptoms overlap with the symptoms of an anal fissure. Both conditions can cause the following:

Bright red blood in the stool, on the toilet paper, or in the toilet bowl after pooping
Anal pain

The main difference between anal fissures and hemorrhoids is when that pain occurs.

Anal fissures cause pain during a bowel movement. The pain can be severe, especially while pushing, and it can linger for minutes or hours after using the bathroom.

Hemorrhoid pain only occurs with an external hemorrhoid or an internal hemorrhoid that is prolapsed (a prolapsed hemorrhoid has fallen outside of the rectum). The pain occurs while sitting, whether on the toilet to have a bowel movement or in a chair.

With the types of hemorrhoids that cause pain (external and prolapsed hemorrhoids), it’s usually possible to feel a lump near the anus. An external hemorrhoid will feel like a hard lump. A prolapsed hemorrhoid is a soft lump that protrudes from the anus.

Pain during a bowel movement without a lump is more likely to be an anal fissure.

A non-prolapsed internal hemorrhoid may bleed, but it won’t create a lump you can feel or cause the intense pain associated with an anal fissure.

Another way to spot the difference is to look for other symptoms. Hemorrhoids can also cause irritation and itching around the anus and a feeling of pressure in the lower rectum.

Is It Possible to Have a Hemorrhoid and an Anal Fissure at the Same Time?

It is possible to have both at once, making it even more confusing to recognize if hemorrhoids or anal fissures are the cause of symptoms.

Straining and pressure can lead to swollen veins and tears in the lining of the anus. These conditions can also both be exacerbated by poor blood flow to the anal area.

The tearing from an anal fissure can cause intense pain, causing the muscles in this area to spasm, which decreases blood flow.

Studies show that people with chronic constipation and hemorrhoids are also more likely to have chronic venous insufficiency, a condition that causes varicose veins and poor blood flow.¹

Poor circulation slows down the movement of oxygen and nutrients to tissue throughout the body, inhibiting the healing process.²

That’s one reason why a proper diagnosis, treatment, and lifestyle changes to prevent future problems are so important. If either one of these anal issues becomes chronic, healing can take longer, and recurrences are more likely, which means more bleeding, pain, and discomfort.

Talk to Hemorrhoid Specialist

Hemorrhoid vs. Anal Fissure Treatment and Prevention Strategies

Many cases of hemorrhoids or anal fissures resolve after a few days without medical treatment. Although the causes are different between hemorrhoids and anal fissures, they both can improve from some of the same strategies. Usually, lifestyle changes help speed healing and prevent future issues.

Eating a high-fiber diet and drinking more water can soften the stool and prevent constipation, resulting in less straining.
Getting regular exercise increases circulation, helping to heal a tear or a swollen vein. Exercise also prevents constipation.
Soaking in warm baths can also increase blood flow to the anal region, helping to relieve discomfort, speed healing, and prevent hemorrhoids and anal fissures.

Sometimes, internal hemorrhoids don’t go away on their own and require medical treatment. They can last for weeks or longer.

Generally, hemorrhoid symptoms that don’t go away after a week should be checked out by a doctor. They can determine if someone has hemorrhoids, anal fissures, or other conditions that can cause rectal bleeding and anal discomfort, like irritable bowel syndrome (IBS) or ulcerative colitis. A hemorrhoid doctor can also recommend the best treatment for the individual.

While colorectal surgeons and gastroenterologists are more commonly associated with treating hemorrhoids, Interventional Radiologists (IR) can offer effective treatments for these conditions.

IRs use minimally invasive imaging techniques to guide procedures, often providing a less invasive and faster recovery time than traditional surgical approaches.

If you’re considering treatment for hemorrhoids, it’s a good idea to discuss your options with both an IR and a colorectal surgeon or gastroenterologist to determine the best approach for your specific situation.

Hemorrhoid treatment can relieve bleeding, swelling, and other symptoms. USA Hemorrhoid Centers offers a non-surgical treatment called hemorrhoid artery embolization (HAE). This minimally invasive procedure is less painful and has a lower risk of complications than other treatments like hemorrhoid surgery and rubber band ligation, making it a good option for most people who need treatment.

Anal fissures usually go away with a high-fiber diet and drinking more water. Over-the-counter stool-softening products and fiber supplements can also help. When anal fissures are chronic, they can be treated with a sphincterotomy, a procedure that relaxes the muscles around the anus.

How to Tell if You Have Hemorrhoids or Anal Fissures?

If you’re dealing with bleeding, pain, and discomfort during or after a bowel movement, it could be hemorrhoids or anal fissures. Knowing the differences between the symptoms can help you understand what type of anorectal issue you’re dealing with. However, a proper diagnosis is the only way to know for sure and to get access to treatment for problems that won’t go away.

Why Choose USA Hemorrhoid Centers

Our doctors are experienced IR hemorrhoid specialists who can evaluate your symptoms, determine the cause, and how to treat them. We offer hemorrhoid consultations and treatment to help our patients return to living hemorrhoid-free.

If you suspect you have hemorrhoids and your symptoms don’t clear up in a few days, schedule a consultation at a location near you. We have clinics nationwide, and all of our locations accept a wide range of insurance.

Schedule a consultation with one of our expert hemorrhoid doctors and get a personalized treatment plan to help you get relief.

Find a Hemorrhoid Clinic near you

Sources

Ekici, U., Kartal, A., & Ferhatoglu, M. F. (2019). Association Between Hemorrhoids and Lower Extremity Chronic Venous Insufficiency. Cureus, 11(4), e4502.
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Overview: Chronic wounds. [Updated 2022 Aug 8].

Do Internal Hemorrhoids Go Away On Their Own?

September 10th, 2024

07:19 PM

If you are struggling with internal hemorrhoids, you are likely seeking relief and hoping for a solution. Internal hemorrhoids can be difficult to get rid of. They can also be extremely uncomfortable and put you at risk of concerning health issues, such as blood loss or an infection.

Hemorrhoids sometimes go away on their own with a few simple lifestyle changes.

However, that doesn’t mean you should ignore symptoms of internal hemorrhoids and hope for the best.

Knowing when to see a doctor about your symptoms is important if they don’t go away. Seeing an Interventional Radiologist can be valuable because they have an in-depth knowledge of blood vessels and their associated conditions, including hemorrhoids. They specialize in performing minimally invasive procedures that offer a less invasive and often more effective approach to treating hemorrhoids.

If you have internal hemorrhoids, understanding how to manage them effectively and when to consult a doctor is essential. Discover tips for relieving painful hemorrhoid symptoms and when you need to seek professional medical attention.

Schedule A Consultation

What Are Internal Hemorrhoids?

Internal hemorrhoids are swollen cushions of veins and other tissue inside the rectum. Unlike external hemorrhoids, which are located outside the rectum, you can’t see or feel internal hemorrhoids.

Internal hemorrhoids are less likely to resolve on their own compared to external hemorrhoids and can lead to more serious symptoms if left untreated. For this reason, most medical treatments for hemorrhoids are designed to target internal hemorrhoids rather than external ones.

Symptoms of Internal Hemorrhoids

Internal hemorrhoids aren’t always painful. However, they can cause itching, irritation, and a feeling of pressure in the rectum when you have a bowel movement.

The most common symptom of an internal hemorrhoid is bleeding.¹You may notice blood in the stool or toilet paper after using the bathroom. Minor blood loss from an internal hemorrhoid that goes away isn’t usually a problem, but an untreated hemorrhoid that doesn’t disappear can lead to an increased risk of complications.

When an internal hemorrhoid pushes through to the outside, it’s called a prolapsed hemorrhoid. This type of internal hemorrhoid is visible and, like an external hemorrhoid, can cause pain. Prolapsed hemorrhoids might make it uncomfortable to sit down, especially for extended periods.

If you experience these symptoms, seeking medical advice is important to receive an accurate diagnosis. Early treatment can prevent complications and provide relief from the discomfort associated with hemorrhoids.

Make your appointment online today

Can Untreated Internal Hemorrhoids Disappear?

While untreated internal hemorrhoids sometimes resolve, it’s important to resolve symptoms promptly to prevent further complications and ensure proper healing.

Risks of Internal Hemorrhoids

Although Internal hemorrhoids are not immediately dangerous, neglecting them can lead to more severe complications. Here are some of the key risks associated with internal hemorrhoids:

Prolapse

Internal hemorrhoids can prolapse, meaning they extend beyond the anus. This can lead to discomfort and complications, as prolapsed hemorrhoids may become trapped and require medical intervention.

Strangulation

In some cases, the blood supply to a prolapsed internal hemorrhoid can be cut off by the anal muscles, leading to strangulation. This condition can cause severe pain and may result in tissue death if not treated promptly.

Thrombosis

Internal hemorrhoids can develop blood clots, leading to thrombosed hemorrhoids. This can cause significant pain and swelling and may require surgical intervention.

Infection

If internal hemorrhoids become prolapsed and collect mucus or stool particles, they can lead to irritation and infection. This can result in conditions such as pruritus ani (itching around the anus)

Bleeding

Internal hemorrhoids can cause bright red bleeding during bowel movements. While this is often not life-threatening, it can be alarming and may indicate more serious conditions, such as colorectal cancer, necessitating further investigation.

Chronic Discomfort

Persistent symptoms such as pain, itching, and discomfort can significantly affect quality of life and lead to avoidance of certain activities, including exercise and social engagements.

Straining

Individuals with internal hemorrhoids may experience increased straining during bowel movements, which can exacerbate the condition and lead to further complications, including worsening hemorrhoids or the development of anal fissures.

When Should You See a Doctor About Hemorrhoid Symptoms?

If internal hemorrhoid symptoms don’t go away after a week or accompany other symptoms, such as bleeding, it’s a good idea to have an experienced hemorrhoid specialist evaluate your symptoms.

See a doctor immediately if you notice severe symptoms, such as dark red blood, severe pain, or more than a small amount of blood loss. These symptoms could be a sign of a more serious health issue, such as colorectal or anal cancer, inflammatory bowel disease, or large anal fissures.

Treatments for Internal Hemorrhoids

When internal hemorrhoid symptoms persist or worsen, treatment may be necessary to alleviate discomfort and prevent further complications. Depending on the severity, various treatment options are available, from non-invasive approaches to surgical procedures. Here are some of the most common treatments:

Over-the-Counter Medications: Creams and ointments that reduce inflammation and ease discomfort.
Rubber Band Ligation: A minimally invasive procedure where a band is placed around the base of the hemorrhoid to cut off blood flow.
Sclerotherapy: A chemical solution is injected into the hemorrhoid to shrink it.
Coagulation Therapy: Laser or infrared light hardens and shrinks the hemorrhoid.
Hemorrhoidectomy: A surgical procedure to completely remove large or prolapsed hemorrhoids.
Stapled Hemorrhoidopexy: This surgery repositions the hemorrhoids and reduces blood flow, causing them to shrink.
Hemorrhoidal Artery Embolization (HAE): A non-surgical procedure that blocks blood flow to the hemorrhoidal arteries, causing the hemorrhoids to shrink.

Hemorrhoidal Artery Embolization (HAE) for Internal Hemorrhoids

If a conservative approach isn’t relieving symptoms, a more advanced hemorrhoid treatment should be considered to address internal hemorrhoids.

Hemorrhoidal artery embolization (HAE) is a non-surgical treatment for internal hemorrhoids. It offers fast relief from bleeding and other symptoms and is extremely safe. Studies have found no serious complications after hemorrhoid embolization.²

Most people with internal hemorrhoids that won’t go away can benefit from HAE. It’s less invasive than surgery and doesn’t cause rectal wounds or issues with anal incontinence. Other treatment options include infrared coagulation, rubber band ligation, and hemorrhoid surgery.

View our patient testimonials

Why Choose USA Hemorrhoid Centers

USA Hemorrhoid Centers is a trusted national network of specialized, non-surgical hemorrhoid treatment centers dedicated to providing effective relief. Our experienced team of hemorrhoid doctors tailors treatments to each individual’s needs, ensuring a personalized and comfortable experience.

Our hemorrhoid specialists are experts in hemorrhoidal artery embolization and are committed to helping patients return to their daily lives free of hemorrhoid symptoms and discomfort.

We also accept most types of insurance and offer affordable payment plans so you can focus on your health without financial stress.

If you’re concerned about hemorrhoid symptoms, schedule a consultation at a clinic near you today.

Find a treatment clinic near you

Frequently Asked Questions

How long do internal hemorrhoids last?

There is no set timeline for hemorrhoids. They can go away in a few days or last for months or years. Some people have recurring hemorrhoids, so it seems like their symptoms never go away.

If internal hemorrhoid symptoms don’t clear up after a week, schedule an appointment with a hemorrhoid doctor for an evaluation.

What are the risks of untreated hemorrhoids?

If a clot forms in the hemorrhoid, it can burst, causing serious blood loss and requiring immediate medical attention.

Blood loss that’s dark red or excessive could also indicate a more serious health condition. Rectal bleeding is a symptom of many different conditions, including hemorrhoids, anal fissures, inflammatory bowel disease (IBD) and colorectal cancer, so it’s important to see a hemorrhoid doctor for an evaluation if you notice regular blood in your stool.

Untreated internal hemorrhoids can also cause anal tears, which can become infected.

Why do internal hemorrhoids need treatment?

If left untreated for too long, hemorrhoids can push out of the rectum and become prolapsed. These hemorrhoids can be painful and make everyday life more uncomfortable. There’s also a risk of blood loss, infection, and a blood clot if an internal hemorrhoid is left untreated for too long.

It’s important to seek medical attention if you experience symptoms of hemorrhoids. Early treatment can help prevent complications and improve your quality of life.

Are internal hemorrhoids permanent?

Internal hemorrhoids aren’t permanent. There are safe and effective treatments that will make even severe internal hemorrhoids go away.

MORE QUESTIONS? TALK TO A HEMORRHOID SPECALIST

References:

Sun, Z., & Migaly, J. (2016). Review of Hemorrhoid Disease: Presentation and Management. Clinics in colon and rectal surgery, 29(1), 22–29.
Reza Talaie,, Pooya Torkian, et all. Hemorrhoid embolization: A review of current evidences. Diagnostic and Interventional Imaging. Volume 103, Issue 1, January 2022, Pages 3-11

Internal vs. External Hemorrhoids: What’s The Difference?

August 5th, 2024

05:59 PM

Are you having issues with rectal bleeding, itching, pain, or other common hemorrhoid symptoms? If so, you might wonder if those symptoms are a sign of internal or external hemorrhoids.

Hemorrhoids are swollen blood vessels in the rectum or under the skin surrounding the anus. Where they form determines whether they are external or internal hemorrhoids.

Although both types of hemorrhoids have the same cause, they can produce different symptoms. There are also varying treatments for internal vs. external hemorrhoids.

Understanding the differences can help you determine what to do next and when to see a hemorrhoid specialist. This guide will answer all your questions about how internal and external hemorrhoids differ, including symptoms and treatment options.

Schedule A Consultation Now

What Are Hemorrhoids?

Hemorrhoids are swollen clusters or ‘piles’ of blood vessels, smooth muscle, and connective tissue. They can be very painful and physically uncomfortable—and even a little embarrassing to talk about.

However, the reality is that most people have hemorrhoids at some point in their lives. One study found that roughly 11% of the adult population suffers from hemorrhoids at any point in time. (1) It’s estimated that by age 50, one in two adults in the US has dealt with hemorrhoid symptoms, such as anal itching, bleeding during bowel movements, or pain. (2)

Hemorrhoids develop because of excess pressure from straining during bowel movements, often due to constipation. A lack of blood flow from prolonged sitting can also cause hemorrhoids, as clusters of blood vessels and connective tissue become swollen and enlarged. Additionally, lifestyle factors, such as diet, weight, and exercise, can also lead to hemorrhoids. It’s important to consult a hemorrhoid specialist to ensure an accurate diagnosis for the cause, type, and management plan for hemorrhoids.

Depending on whether the hemorrhoids are external or internal, you might experience different symptoms. Regardless, it’s important not to leave hemorrhoids untreated.

Internal Hemorrhoids

Internal hemorrhoids occur in the lower rectum, inside the anal cavity, making them invisible from the outside.

A person with an internal hemorrhoid might notice bright red blood on their toilet paper or in their stool. They may not experience pain as there are fewer sensory nerves in the rectal area.

However, an internal hemorrhoid can cause pain or irritation if it pushes through the anal opening, a condition known as prolapse. A prolapsed hemorrhoid occurs when the connective tissue holding the blood vessels in place can no longer support them, causing a small lump to form at the anus.

External Hemorrhoids

External hemorrhoids develop around the anus. Compared to internal hemorrhoids, external ones are more likely to cause pain and discomfort because there are more pain-sensing nerves under the skin near the anus.

Other possible symptoms include:

Swelling around the anus
Itching
Bleeding
Lumps
Pain or discomfort

External hemorrhoids can cause severe pain if a clot develops A hemorrhoid with a blood clot is called a thrombosed hemorrhoid. This can also occur with internal hemorrhoids but is not as common. It looks like a hard lump near the anus and can cause swelling and inflammation that makes sitting extremely uncomfortable.

Diagnosing External vs. Internal Hemorrhoids

A hemorrhoid doctor will review your medical history to determine whether external or internal hemorrhoids are causing symptoms. They will ask about your eating and toilet habits and any existing medical conditions.

An interventional radiologist, also known as a hemorrhoid doctor, will also perform an exam:

To diagnose external hemorrhoids, the doctor will examine the area around the anus, assessing any existing lumps to make a diagnosis.
Diagnosing internal hemorrhoids is more complex because they occur inside the rectum and are not visible. The doctor will perform a digital rectal exam using ultrasound imaging technology.

Treating External vs. Internal Hemorrhoids

Treatment for internal hemorrhoids differs from the treatment for external hemorrhoids.

External hemorrhoids are often easier to treat. Home treatments can often provide temporary relief from hemorrhoids within a couple of weeks, such as:

Sitting in a warm bath can relieve pain and discomfort.
Eating more fiber and drinking more water can help loosen your stool, preventing further straining.
Topical creams or ointments for hemorrhoids can ease itching and swelling.

Internal hemorrhoids are more likely to require medical treatment. Some mild hemorrhoids can be temporarily relieved through home remedies, but a medical diagnosis and treatment plan from a hemorrhoid specialist are recommended. If you still notice symptoms after a few days, it’s important to see a hemorrhoid doctor.

There are several treatments for internal hemorrhoids, including surgical removal and non-surgical procedures that can effectively relieve symptoms.

Hemorrhoid artery embolization (HAE) is a non-surgical procedure that shrinks existing hemorrhoids by stopping blood flow to the pile. It’s a good option for people who want to avoid the pain and discomfort associated with other treatments.
Hemorrhoidectomy is surgical hemorrhoid removal. This procedure does come with some risks, including bleeding post-treatment, so it’s usually only recommended for severe cases.
Rubber band ligation involves tying rubber bands around internal hemorrhoids, which causes them to fall off. This procedure can be painful, and some may experience post-treatment discomfort.
Sclerotherapy involves injecting a medical solution into the hemorrhoids, which stops blood from reaching the hemorrhoid, causing it to shrink.

When to See a Doctor for Hemorrhoids

If hemorrhoid symptoms persist for more than one week or if you have severe pain or bleeding, you should see a doctor for a diagnosis and to learn about your treatment options.

USA Hemorrhoid Centers is a leading network of outpatient hemorrhoid treatment centers. We offer non-surgical hemorrhoid treatment and personalized treatment plans. Schedule a consultation at a location near you today and find out how we can help you get back to living hemorrhoid-free.

Find a Hemorrhoid Center Near You

FAQs

How do you know if you have an internal or external hemorrhoid?

If a hemorrhoid is under the skin around your anus and is painful, it’s likely an external hemorrhoid.

An internal hemorrhoid is more difficult to identify. You can’t see or feel the lump. Also, blood in the stool could be caused by a more serious health condition, such as inflammatory bowel disease or colon cancer. It’s not always clear whether bleeding is related to hemorrhoids.

To find out for certain if you have internal hemorrhoids, external hemorrhoids, or both, schedule a consultation with a hemorrhoid specialist near you.

Can external hemorrhoids become internal?

External hemorrhoids can’t become internal hemorrhoids. However, a prolapsed hemorrhoid, which is an internal hemorrhoid that bulges outside of the anus, may go back inside on its own.

Can you have both internal and external hemorrhoids at the same time?

Yes, you can have internal and external hemorrhoids at the same time. That can make it more difficult to figure out if your symptoms are caused by one type of hemorrhoid or another. A hemorrhoid doctor can give you an accurate diagnosis and recommend a treatment plan for the specific types of hemorrhoids you have.

Internal vs. external hemorrhoids: which are worse?

External hemorrhoids can cause more discomfort. They can lead to itching, swelling, and pain, as well as bleeding. Internal hemorrhoids aren’t always painful. However, they can be harder to get rid of. People with moderate to severe internal hemorrhoids may require medical treatment to help alleviate their symptoms.

Are external or internal hemorrhoids more common?

External hemorrhoids are more common than internal hemorrhoids.

References:

Sheikh, Parvez et al. The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey.Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2020-0159
LeWine, Howard E. MD. Hemorrhoids and what to do about them. Harvard Health Publishing. www.health.harvard.edu/diseases-and-conditions