Fissure/Hemorrhoid Differences?

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Fissure/Hemorrhoid Differences?

Postby AlexP » 24 Nov 2013, 18:01

Wondering if someone can spell out the difference between hemorrhoids & anal fissure? I've had family members who've had hemmorhoids removed. My doc thinks I have a fissure, but am not in pain all the time only when I have BM, specifically when it first comes out, it stings a bit. Minor spotting, but basically that's it. Just the stinging pain. I have two small skin tags which CRS claimed weren't worth removing surgically. But then two weeks later my primary doc looked at me & claims he saw a fissure (didn't do an anoscopy, just looked outside). Oh, and back in July, when I saw the CRS for follow-up after my colonoscopy, I didn't have the stinging at that point. This seemed to all start after a bad episode of constipation about a month ago.

So how do I know for sure if I have a fissure or hemorrhoid? The main reason I want to know is so I can get the right ointment. Visually, my skin tags don't look inflamed, I can't tell if I have hemmorrhoids or not. is hemmorrhoid pain different from fissure? My fissure (if that's what it is) is on one side, & feels like a sharp stinging which is rather brief, when passing stool. Not a constant pain, never an ache. Physical activity doesn't seem to bother me. In a few more days, if the current ointments don't start helping the stinging, I'll have to try a different cream.
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Re: Fissure/Hemorrhoid Differences?

Postby Scientist2516 » 25 Nov 2013, 10:20

Hi Alex,
A fissure is a cut in the skin of the internal anal sphincter. Sometimes it can be seen from the outside, sometimes not. Often, as a fissure becomes chronic, a skin tag will form on the outside of the anus corresponding to where the fissure is.
A fissure will cause pain during a BM and sometimes afterwards.

Hemorrhoids are swollen blood vessels. They can be internal or external. Internal hemorrhoids are apparently painlesss, but can cause blood on the toilet paper. They can prolapse to the outside and become very painful. External hemorrhoids are lumps on the outside of the anus. They can be uncomfortable or very painful, depending. A thrombosed hemorrhoid (with a blood clot in) is painful. I had a big thrombosed hemorrhoid before I got my fissure, and it was painful. After it went away I was left with some loose skin remaining after the swelling went down.

Fissures are usually at the midline of the anus, usually at the back, because these areas normally have the lowest blood supply. A fissure to one side might indicate some underlying problem. So if your pain is to one side it might not be a fissure. However, many people with fissures get "referred pain" which means they feel the pain in different areas. I certainly had a lot of pain well away from the fissure.

It's really hard to say what's going on with you, especially if your doc says something different from your CRS. If you don't have after spasms, that also argues against a fissure, but I would not like to say anything definite.
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Re: Fissure/Hemorrhoid Differences?

Postby sugarspice » 25 Nov 2013, 13:56

Hi AlexP, I have had hems (internal/external/thrombosed) and I currently have a chronic fissure. I can describe the difference between the two....

Fissure - Pain when going to the loo (burning pain) and pain afterwards. Initially when the fissure is not too bad the pain reflects that, but when it's chronic it's like passing broken glass and the pain lasts most of the day, plus shooting pains.

Hems - Painful (especially thrombosed) but it feels like you have something uncomfortable inserted in to your bum, so it hurts to sit down and you want to lean to one side, if it's external and is hard to the touch (like a pea) it's more painful. But a fissure is a burning pain, the pain is definitely different. And if you have a chronic fissure you want to jump off the nearest building but if you have a nasty thrombosed hem you just want to cry.

Hope that helps?? lol
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