Though they may have similar symptoms in some cases,anal fissuresandfistulasare different conditions.
An anal fissure is a crack or a tear in the tissue of the anus.
A fistula is when a tunnel or connection forms between two organs or the organ and the skin.
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Fissures and fistulas can both cause pain and bleeding.
However, they are treated differently, so its important to tell them apart.
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Symptoms
An anal fissure and a fistula can have similar symptoms.
Rectal bleeding and pain during bowel movements are symptoms of both conditions.
But other signs and symptoms of these conditions can help differentiate between them.
Anal Fissure
An anal fissure begins as a tear in the lining of the anus.
The development of a fistula in the anal area commonly begins with an infection.
It starts as anabscess, which is a pocket of pus.
In some cases, this may create a lump or a bump under the skin in the anal area.
This abscess may eventually break open, creating a passage between two organs, a fistula.
Let your provider know of any bleeding, itching, and burning you have had.
A history of changes in bowel movements is also important to bring up, including diarrhea and constipation.
The duration of symptoms, such as how many times a day or week, is important.
Keeping a diary of symptoms can be helpful when working with a healthcare provider.
In some cases, the fissure will be seen during a physical exam of the anal area.
An abscess might be seen during an exam by a healthcare provider.
In some cases, adigital rectal examis done.
A gloved, lubricated finger is quickly inserted into the rectum to check for any lumps.
More complex or persistent fissures may need treatment with prescription medications or surgery.
An abscess might also be treated by draining the pus that has formed from the infection.
Drainage is usually done as an outpatient procedure.
Setons: A seton is a loop of material thats threaded through the tract of the fistula.
Its made of flexible materials such as silicone, nylon, silk, or a surgical suture.
Medications: Prescription medications might be used to help the abscess and/or the fistula heal.
Antibiotics can help clear up an infection.
Surgery:Different types of surgerymight be used to heal a fistula.
Ostomy surgery may be needed in complex cases.
In this procedure, part of the intestine is brought through the wall of the abdomen, creating astoma.
Stool leaves the body through the stoma and is caught in an appliance worn on the abdomen.
The appliance is emptied into a toilet when needed.
Sometimes the ostomy is removed when the fistula heals.
In this case, the ostomy will become permanent.
Prevention
It wont always be possible to prevent a fissure or a fistula.
Exercise, dietary fiber, hydration, and avoiding straining on the toilet may help prevent an anal fissure.
Anal Fistula
A fistula may not be preventable in some cases.
If you have Crohns disease, ensuring the condition is well-managed may help prevent complications such as a fistula.
See a healthcare provider regularly and especially when something seems different about bowel movements.
A Word From Verywell
Having symptoms with a bowel movement can be upsetting and frustrating.
Caring for your digestive health includes everything from diet and hydration to exercise to seeing healthcare providers regularly.
Frequently Asked Questions
With treatment, the symptoms should start to improve after a few days.
The pain might start to subside quickly, but the fissure could take some weeks to fully heal.
After four to five weeks, there should be some progress in healing.
If not, it may be time to consider more intensive treatment.
You should seek care right away for a lump or a bump around the anus.
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