Difference Between Fistula and Hemorrhoids

Fistula and hemorrhoids are two common conditions that affect the anus and rectum. Although they may share some symptoms, these conditions are different and require different treatment approaches. In this essay, we will discuss the difference between fistula and hemorrhoids.

What is Fistula?

A fistula is an abnormal connection or tunnel that forms between two body cavities or between an organ and the skin. In the case of an anal fistula, it is a tunnel that connects the anus or rectum to the skin surrounding the anus. Fistulas are usually caused by an infection or inflammation in the anal region, such as an abscess. They can also be a complication of certain medical conditions, such as Crohn's disease or tuberculosis. Symptoms of an anal fistula may include pain, swelling, redness, and discharge of pus or blood from the anus.

Symptoms and prevention − A fistula between the anus and rectum has symptoms such as pain and also a foul-smelling discharge is often present. The rectovaginal fistula forms between the vagina and rectum and thus will often have symptoms related to the passage of feces into the vagina, which can lead to infections and a foul-smelling discharge from the vaginal canal.

Diagnosis and causes − Fistulas are detected by means of a physical exam and sometimes by means of a CT scan. A contrast medium can be injected as well in order to see if contents are leaking into the skin or vagina if a doctor is uncertain about the presence of a fistula. Childbirth or various inflammatory bowel conditions such as Crohn’s disease can often cause a fistula to develop.

Risk factors and treatment − Risk factors for the development of a fistula include having Crohn’s disease or even having problems giving birth. Surgical intervention is often needed to correct the fistula. When surgery is done, any infected material present has to be removed first before closing the connection to ensure that no systemic infection develops.

What are Hemorrhoids?

Hemorrhoids are swollen veins in the rectum and anus that can cause discomfort, pain, and bleeding. Hemorrhoids can be internal or external. Internal hemorrhoids occur inside the rectum and are not visible, while external hemorrhoids are located outside the anus and can be seen and felt. The main causes of hemorrhoids include constipation, pregnancy, obesity, and aging. Symptoms of hemorrhoids include itching, pain, bleeding during bowel movements, and swelling around the anus. Hemorrhoids can be diagnosed through a physical examination or by performing a colonoscopy or sigmoidoscopy.

Symptoms and prevention − There may be no symptoms but sometimes a person can have pain and there may be bleeding that occurs upon defecation in some cases. Prevention of hemorrhoids involves avoiding straining during constipation. Constipation should be treated using stool softeners to help reduce the need for straining during defecation.

Diagnosis and causes − A physical exam in which the anus is examined can determine if you have hemorrhoids. An anoscopy, sigmoidoscopy, or colonoscopy can also show the presence of internal hemorrhoids. Hemorrhoids can be caused by straining due to constipation, or from lifting heavy weights. Occasionally pregnancy can also lead women to develop hemorrhoids.

Differences: Fistula and Hemorrhoids

One of the main differences between fistula and hemorrhoids is their location. Fistula is a condition that affects the anal glands, while hemorrhoids affect the veins in the rectum and anus. Fistula is often caused by an infection or an abscess, while hemorrhoids are mainly caused by constipation and other factors that increase pressure in the anal area.

Another difference between fistula and hemorrhoids is their treatment. Fistula usually requires surgery to remove the abnormal channel and repair the tissues. There are several surgical options for fistula, including fistulotomy, seton placement, and advancement flap surgery. Hemorrhoids, on the other hand, can be treated with non-surgical methods such as dietary changes, stool softeners, and sitz baths. In severe cases, hemorrhoids may require surgery, such as hemorrhoidectomy or stapled hemorrhoidopexy.

The following table highlights the major differences between Fistula and Hemorrhoids −





A fistula is an unusual connection or tunnel that develops between two parts of the body such as between the anus and the skin and the rectum and vagina.

Hemorrhoids are swollen, dilated veins that occur in the anal canal.


Symptoms of a fistula are pain and an unpleasant and foul-smelling discharge.

Symptoms of hemorrhoids include pain and sometimes bleeding when defecating.


Fistulas can be caused by some type of trauma, such as difficult childbirth; and they can be caused by certain inflammatory bowel conditions such as severe Crohn’s disease.

Hemorrhoids may be caused by childbirth and are often the result of straining during defecation because of severe constipation.

Risk factors

Having an inflammatory bowel disease such as Crohn’s disease is a risk factor for fistula development as are certain surgeries, or difficult childbirth.

Suffering from chronic and severe constipation is the main risk factor for the development of hemorrhoids.


Fistulas are generally best treated by a fistulotomy surgery.

Hemorrhoids may need to be treated by having a hemorrhoidectomy surgery, but in mild cases can be treated by anesthetic creams or warm sitz baths.


Fistulas can be prevented by better treatment of inflammatory bowel problems.

Hemorrhoids can be prevented by using stool softeners to prevent constipation and straining during defecation.


In conclusion, fistula and hemorrhoids are two different medical conditions that affect the anus and rectum. Fistula is a channel that forms between the anus and the skin around the anus, while hemorrhoids are swollen veins in the rectum and anus.

Fistula is usually caused by an infection or an abscess, while hemorrhoids are mainly caused by constipation and other factors that increase pressure in the anal area. Fistula requires surgery, while hemorrhoids can be treated with non-surgical methods or surgery in severe cases.

It is important to consult a doctor if you experience any symptoms related to these conditions to get an accurate diagnosis and appropriate treatment.

Updated on: 06-Apr-2023


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