Fissures and : Fistula are 12 different things. Fissures usually cause a severe tearing like pain with bm and severe spasm in the sphincter after a bm and may have significant bleeding, fistula is usually a pressure type pain and may drain a mixture of blood and infected fluid or purulence. They are treated differently so a correct diagnosis requires an exam. Both may require surgery but not the first choice.
Answered 10/20/2018
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