What are the differences between anal fistula and hemorrhoids?

Jul 15, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

In general, the main differences between anal fistula and hemorrhoids include the presence of bleeding, pain symptoms, location of the lesion, triggering factors, and effects on bowel movements. If discomfort occurs, it is recommended to seek timely treatment at a reputable hospital. In daily life, it is important to maintain anal hygiene, avoid prolonged sitting, follow a reasonable diet, and maintain regular bowel movements to reduce the risk of developing anorectal diseases.

Generally speaking, the main differences between anal fistula and hemorrhoids include the bleeding condition, pain manifestation, lesion location, inducing factors, and effects on defecation. If discomfort symptoms occur, it is recommended to seek timely treatment at a regular hospital. Detailed analysis is as follows:

1. Bleeding Condition

Anal fistulas rarely involve bleeding; when it does occur, it is usually small amounts of blood-tinged purulent discharge or slight oozing when the fistula ulcerates. Hemorrhoidal bleeding is more common, typically bright red blood, manifesting as dripping blood, jet-like bleeding, or blood on toilet paper. The blood does not mix with the stool and usually appears during bowel movements.

2. Pain Manifestation

During the inactive phase, anal fistulas cause mild discomfort, mainly a feeling of heaviness in the anus. During acute episodes, due to infection and inflammation of the fistulous tract, significant pain occurs, intensifying as the inflammation worsens. Hemorrhoids generally do not cause pain, but severe pain may occur when internal hemorrhoids prolapse and become incarcerated or when a thrombosis develops in external hemorrhoids, causing sudden sharp pain in the anal area.

3. Lesion Location

An anal fistula consists of three components: an internal opening, fistulous tract, and external opening. The internal opening is usually located near the dentate line, the tract passes through the perianal tissue, and the external opening is located on the perianal skin. Hemorrhoids are venous clusters formed by congestion and dilation of the venous plexus beneath the mucosa of the lower rectum and anal skin. Internal hemorrhoids are located above the dentate line, while external hemorrhoids are located below it.

4. Inducing Factors

Anal fistulas are commonly formed after rupture of perianal abscesses and are closely related to anal gland infections. Poor hygiene habits and low immunity may also be contributing factors. Hemorrhoids are often caused by increased abdominal pressure, such as constipation, prolonged sitting or standing, pregnancy, and obesity, which lead to elevated pressure and tortuous dilation of the venous plexus.

5. Effects on Defecation

Patients with anal fistulas may experience some discomfort or pain during defecation, and the discharge from the fistula may soil underwear, causing inconvenience in daily life. Patients with hemorrhoids usually do not experience significant changes in bowel habits, although a feeling of incomplete evacuation may occur when internal hemorrhoids prolapse, and pain may cause fear of defecation.

In daily life, it is important to maintain perianal hygiene, avoid prolonged sitting, eat a balanced diet, and ensure smooth bowel movements to reduce the risk of anorectal diseases.

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Is it effective to apply tea seed oil on hemorrhoids?

In general, tea oil cannot cure hemorrhoids and may only provide limited relief in the early stages. If bleeding or pain persists for more than one week or progressively worsens, medical attention should be sought immediately. A specialist can then evaluate the condition and recommend appropriate treatments, such as suppositories or ointments containing local anesthetics, steroids, or vasoconstrictors, or perform minimally invasive procedures or surgery. Tea oil can only serve as a temporary adjunct and should not replace proper medical treatment.

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What should I do if my hemorrhoids bleed every time I have a bowel movement?

Defecation usually refers to bowel movement. In general, rectal bleeding immediately after defecation may be caused by factors such as stool friction against hemorrhoidal tissue, increased abdominal pressure during bowel movements, prolapse of internal hemorrhoids, incarcerated mixed hemorrhoids, or thrombosed external hemorrhoids. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through conservative management, medication, surgical treatment, or other appropriate methods.

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What should I do if I have bleeding during bowel movements due to internal hemorrhoids?

In general, the treatment methods for bleeding internal hemorrhoids mainly include conservative management, local medication, oral drug therapy, physical therapy, and surgical treatment. In addition, patients should follow medical advice for standardized treatment and undergo regular follow-up examinations. If abnormal conditions such as heavy or persistent bleeding occur, timely medical consultation is necessary to adjust the treatment plan.

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What could be the reason for a lump growing near the anus?

The term "butt hole" usually refers to the anus. Common causes of a lump near the anus include prolonged sitting and pressure, dietary irritation, external hemorrhoids, perianal abscess, rectal prolapse, etc. If discomfort occurs, it is recommended to seek timely medical evaluation and treatment at a正规 hospital. In daily life, avoid prolonged sitting or standing, engage in appropriate physical activity, maintain a light diet, and prevent constipation.