What is the distinction between anal fissure/fistula and hemorrhoid?

Different problems: An anal fissure is a tear in the lining of the anal canal causing pain and bleeding. An anal fistula is a tunnel from inside the anal canal out to the perianal skin. It may cause drainage, pain and swelling. There are internal hemorrhoids which may prolapse and cause bleeding, discomfort and itching, and external hemorrhoids which may cause pain or difficulty with cleaning.

Pain: Hemorrhoids are usually only painful if they are thrombosed. A thrombosed hemorrhoid usually presents with a large, tender bump on the anal area. Fissure usually presents with severe pain with bowel movements and bright red blood. People often describe a sensation like razor blades or knives when they pass stool. Fistula is associated with drainage, and not usually painful unless there is abscess.

All Different: Fissure: think paper cut in your anus hemorrhoids: think varicose veins in the anus fistula: much more complex - think aberrant tract from rectum to skin that shouldn't be there.

All different: An anal fissure is a small tear in the mucosa that lines the anus. An anal fistula is tract between the anal canal and the skin. A hemorrhoid is a 'varicose (dilated) vein" of the anal canal.