Difference between fistulas and hemorrhoids

Before starting to mention the differences between fistulas and hemorrhoids , we will indicate what each of them is and its most characteristic symptoms.

What are fistulas and hemorrhoids?

The fistulas are a connection between two areas of the body that should not join. For example, between an organ or a blood vessel. In general, they usually appear because of an injury or surgery, although they can also be caused by infection or inflammation.

The most common symptoms in the case of fistulas are:

  • Very intense pain before and after the act of defecating
  • Small presence of blood
  • Pus in the stool and underwear
  • Possibility of fever
  • In general, blood does not mix with feces.

The only possible treatment for them is surgery . Therefore, doctors recommend prevention with good anal hygiene, a balanced diet and avoid sedentary lifestyle. In these preventive aspects coincide with hemorrhoids.

As far as fistula surgery is concerned, it should also be performed by a specialist physician of the colon and rectum who, during the intervention, will analyze the extent and depth of the fistula. Almost all fistulas are operated by cutting the skin and muscle above the tunnel and leaving an open groove (fistulotomy).

Thus, the fistula will heal from the inside and out. In the case of more complex fistulas, the inclusion of special drainage, called seton, will be required for six weeks, after which the final operation will be performed. The surgery that is applied to the fistulas is performed on an outpatient basis, except for those cases that are very deep or large and the patient needs to spend a few days in the hospital.

In the postoperative period of the fistula, the doctor may recommend soaking the damaged area with a warm water bath and taking stool softeners or laxatives for a week. The patient may also experience pain and discomfort in the area and have to take painkillers. Usually, fistulas heal after surgery without problems.

The Hemorrhoids are dilated veins in the anal canal or lower rectum. It is believed that they appear due to chronic constipation, diarrhea, pregnancy , childbirth, being overweight, remaining standing or sitting for a long time or making efforts to defecate. There are two types , depending on the area of ??the year in which they are located: internal and external . Its treatment will depend on the degree of severity of the hemorrhoid, not having to be operated surgically (only in 20% of cases).

Treatment of hemorrhoids

The treatments in the hemorrhoids are wide: conventional remedies , ambulatory treatments and surgical treatments .

The conventional remedies are:

  • Seat baths with warm water for 10 or 15 minutes
  • Use of hemorrhoidal creams to relieve their symptoms
  • Eat a balanced diet
  • Wear unadjusted clothes and cotton underwear
  • Do not drink alcohol, coffee or spicy
  • To clean with baby wipes and not with toilet paper
  • Take analgesics orally

The outpatient treatments are:

  • Sclerosing injections
  • Realization of ligature with elastic bands
  • Coagulation with laser or infrared light
  • Cryotherapy

Hemorrhoid surgery

And finally, and as more aggressive treatments, there is surgery :

  • Hemorrhoidectomy (open and closed)
  • Circular mucosal anopexy
  • Transanal Hemorrhoidal Dearterialization

In the case of hemorrhoids, the doctor also advises prevention and this is similar to that of fistula: balanced diet , moderate daily exercise , good anal hygiene, not always staying in the same position or not making efforts to defecate.

Where do the fistulas appear and where are the hemorrhoids?

The fistulae , unlike hemorrhoids, may appear in different zones of the human body between the neck and throat, between an artery and a vein, including the bile duct and the surface of the skin between the cervix and the vagina , between the intracranial space and a paranasal sinus, between the colon and the surface of the body (causing the stool to leave a different place to the anus) or between the stomach and the cutaneous surface.

There are diseases that can cause them such as Crohn’s or ulcerative colitis leading to fistulas between two intestinal areas. In addition to diabetes or a weak immune system. Anal sex can also cause them.

Finally, note that an injury can cause fistulas to form between arteries and veins.

The types of fistulas are:

  • Complete : have openings both inside and outside the body
  • Blind : they are only open at one end but they connect two structures
  • Incomplete : they are a tube from the skin closed inside and does not connect anything
  • In horseshoe : connect the anus with the surface of the skin after surrounding the rectum

Of hemorrhoids there are only two types :

  • Internal : they are inside the anal canal
  • External : prolapse outside the anal canal

Symptoms of fistulas and hemorrhoids

Fistulas, unlike hemorrhoids, can cause fever. Another symptom is tiredness, tremors, irritation of the skin around the anus due to pus secretions, pain when defecating, discharge with blood from an opening surrounding the anus, swelling in the anus and recurrent anal abscesses.

Hemorrhoids cause pain, itching, bleeding and discomfort in the anal area.


Both pathologies can occur in the anal canal, although in the case of fistulas we have found that it can occur in other areas of the body. Hemorrhoids usually do not present pain in the first stages but the fistulas always hurt – although they both bleed. In addition, fistulas can cause fever and pus, which is more unusual in the case of hemorrhoids.

For hemorrhoids there are more alternatives -in their early stages- than for fistulas, whose only solution is surgery.

In the case of having to resolve the hemorrhoids with surgery, as with fistulas, the postoperative periodproduces pain for both conditions.

In both cases, prevention involves maintaining good habits of life, with a rich and balanced diet, sport and proper hygiene.

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