Can I Have a Hemorrhoid and a Fissure at the Same Time?

Medically reviewed by: Gary H. Hoffman, MD

Hemorrhoids and anal fissures can occur separately or together. Because they both cause similar symptoms, they are often confused by sufferers who try to self-diagnose their conditions. Both cause painful bowel movements, can cause itching and burning, and may cause bright red blood in the stool or on toilet paper. They also share some of the same causes, so it only makes sense that some people develop both at the same time.

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What Do I Need to Know About Hemorrhoids?

Hemorrhoids can occur inside or outside the anal opening. The painful burning many people associate with hemorrhoids usually comes from external hemorrhoids. Internal hemorrhoids usually have no symptoms unless they bleed. They can prolapse and become stuck outside, in some cases.

Generally, hemorrhoids are more irritating than dangerous, although severe bleeding is possible infections are rare. Usually, infections only occur in people who avoid talking to a doctor about their symptoms and a prolapsed hemorrhoid loses blood flow. It is always a good idea to see a doctor when you experience painful bowel movements or other symptoms.

Hemorrhoids generally occur after bouts of constipation or diarrhea. Straining to pass hard stools, in particular, can irritate these sensitive tissues. With hemorrhoids, you can expect to experience burning and swelling during and after using the bathroom, and you may see bright red blood on your stool or on the toilet paper.

What Is an Anal Fissure?

Anal fissures are cracks that occur in or near the anal opening. The pain and burning during a bowel movement and the blood on the toilet paper mean fissures are often confused with hemorrhoids. We often see patients who believe they have hemorrhoids who actually have an anal fissure, or they have both.

Like hemorrhoids, anal fissures often develop when you strain to pass a hard stool. The stool stretches and tears the tender skin, causing a fissure. Chronic diarrhea is also a common cause of fissures. Those who suffer from recurrent loose stools may be at an increased risk.

Infections are more common with anal fissures than with hemorrhoids, because of the broken skin. If a fissure does not heal on its own or you develop signs of an infection, you may need more intensive treatment.

Do I Need to See a Doctor If I Believe I Have Hemorrhoids, a Fissure, or Both?

In addition to hemorrhoids and fissures, other more serious health concerns may also cause similar symptoms. An abscess or even anal or rectal cancer might be to blame. For this reason, you should see a doctor anytime you believe you have hemorrhoids, a fissure, or both. You need an accurate diagnosis, and help getting the right treatment for your condition.

When you visit our office, we will take a health history and ask you about your symptoms. Then, we will perform a quick visual examination to determine the cause of your symptoms. Hemorrhoids and fissures may require different treatments, so an accurate diagnosis is especially important.

We may prescribe sitz baths to reduce pain and swelling, and a high fiber diet to help prevent constipation. This can sometimes give both hemorrhoids and fissures a chance to heal on their own. However, if they persist, we may need to consider other treatment options. In the most serious cases, you may require surgery to repair a fissure or to remove your hemorrhoids.

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