What is the difference between hemorrhoidal fistula and hemorrhoids?

Generally speaking, the main differences between anal fistula and hemorrhoids lie in symptom presentation, lesion characteristics, causes, disease progression, and treatment methods. If discomfort symptoms appear, it is recommended to seek timely treatment at a regular hospital. Specific analysis is as follows:

1. Symptom Presentation

Anal fistula mainly presents as recurring pus discharge and itching around the anus. The external opening of the fistula may temporarily close but will later rupture and discharge pus again. During acute episodes, there may be redness, swelling, pain in the affected area, and possibly fever. The main symptom of hemorrhoids is rectal bleeding, typically bright red blood dripping or spurting out. When internal hemorrhoids prolapse, soft masses can be seen outside the anus. Thrombosed external hemorrhoids may cause sudden anal pain, but there is no pus discharge.

2. Lesion Characteristics

Anal fistula is an abnormal passage around the anus consisting of an internal opening, fistulous tract, and external opening. It is often a sequela following the rupture of a perianal abscess and is classified as an infectious, chronic condition that cannot heal spontaneously. Hemorrhoids are swollen venous clusters formed by congested and dilated venous plexuses in the lower rectum and anal canal. They are benign hyperplastic lesions and non-infectious diseases, some of which can improve with conservative treatment.

3. Causes

Anal fistulas mostly form after incomplete treatment or spontaneous rupture of perianal abscesses and are closely related to chronic inflammation caused by anal gland infection and fecal contamination. Hemorrhoids commonly result from increased abdominal pressure, such as long-term constipation, prolonged sitting or standing, and pregnancy, which hinder venous return and cause congestion and dilation of the venous plexus.

4. Disease Progression Relationship

Anal fistulas do not develop directly from hemorrhoids, but recurrent prolapse and infection of hemorrhoids may trigger perianal abscesses, which can then progress into anal fistulas. If hemorrhoids remain untreated for a long time, symptoms may gradually worsen, leading to prolapse incarceration and increased rectal bleeding, but fistulas will not form.

5. Treatment Methods

Anal fistulas must be treated surgically, such as through fistulotomy or seton techniques, to completely remove the lesion; conservative treatment cannot achieve a complete cure. Mild hemorrhoids can be relieved through dietary adjustments and topical medications, while severe cases may be treated with injection therapy, rubber band ligation, or surgical excision. Fistula management is unnecessary in such cases.

In daily life, maintaining perianal hygiene, avoiding prolonged sitting, and preventing constipation are important for preventing anorectal diseases. If symptoms such as anal pus discharge and recurring pain occur, anal fistula should be suspected, and timely medical attention sought to avoid prolonged illness.