Anal Fissure vs Fistula: What Are the Differences?

11 January 2018
 Categories: , Blog


Since most people rarely discuss their most delicate medical problems, it's a common misconception that the terms anal fissure and anal fistula both refer to the same kind of injury. Since the two words do sound similar and there are few chances for most people to be corrected, it's a widespread misunderstanding. However, these two injuries are very different. The following information will help you understand each medical issue.

What is a Fissure?

An anal fissure is a tear in the tissue of the rectum or anal canal. This can occur due to an abnormally large, sharp, or hard bowel movement, a sudden movement like a cough or sneeze while using the toilet, or activities like riding a bike or horse. Sometimes people develop fissures without knowing why and simply experienced symptoms like a burning sensation during defecation and bright red blood on their toilet paper. Fissures tend to be short-term problems that heal up within 6 weeks on their own, as long as you can avoid the original activity or action that caused the tear in the first place.

What is a Fistula?

The term fistula sounds similar to fissure, but it refers to a tube that forms in your anal canal due to an infection that damages the skin as it heals. The tube forms because the skin in your rectum and anal canal heals quickly while infection still lingers under the surface. The fistula can be hard to notice and it may cause the same bleeding symptoms as a fissure.

Fistulas tend to cause more intense pain than fissures, yet that's hard to judge by yourself if you've never had either problem before. Fissures never cause pus, while fistulas do create pus that may or may not be noticeable when you're using the restroom. A vague and general sense of being ill and running a fever are the most common symptoms of a fistula, which is why it's best to see a proctologist that provides anal treatments promptly if you suspect a rectal problem.

Why are Fistulas More Serious?

A fissure that doesn't heal can develop an abscess, and these abscesses create fistulas if they're not treated either. Fistulas are more serious because they harbor a protected infection that can spread rapidly to other parts of your body when normal bathroom activities tear the sensitive tissue and let the bacteria enter the bloodstream. They also never resolve on their own due to the trapped bacteria and constant reintroduction of fecal matter. A doctor must open the canal, remove any unnecessary tissue, and clean out the infection before you will completely heal. Without treatment, a fistulas can also cause rectal cancer as well.