Anal Fissure VS. Fistula: A look At The Differences

If you or a loved one is suffering from an anal condition, you’ll know that they can be incredibly uncomfortable and, quite frankly, annoying. In this blog, we’ll answer some common questions we hear at Suncoast Surgical Associates: can a fissure turn into a fistula, how do you know if you have a fistula, and how do you heal an anal fissure? Let’s jump right in.

Anal Fissures vs. Anal Fistulas

Similarities Between Anal Fissures & Fistulas

Anal fissures and fistulas are two common conditions that can affect the anus. They can both cause pain and bleeding, and they can be difficult to treat. However, there are some important differences between the two conditions.

Differences Between Anal Fissures & Fistulas

An anal fissure is a tear in the lining of the anus. It is caused by passing hard or large stools, and it can be very painful. Anal fissures are most common in people who are constipated, but they can also be caused by diarrhea, Crohn's disease, and other conditions. Anal fissures can take a few weeks to heal and may require surgical repair. The symptoms are:

  • Pain during and after bowel movements

  • Bleeding, itching, or swelling around the anal opening

An anal fistula is an abnormal connection or tunnel between the anus and the skin around the anus. It is caused by an infection in the anal glands, and it can be very painful. Anal fistulas are more common in people who have Crohn's disease, HIV, or other conditions that weaken the immune system. Anal fistulas will normally heal on their own within a few months, but may require surgery to repair. Fistula symptoms include:

  • Pain in the anal area - constant, or may come and go

  • Drainage of pus from the area

  • Swelling and redness in the area

  • Itching and burning in the area

Treating Anal Fissures & Fistulas

For both conditions, it’s likely that the condition will resolve on its own – however, infection is the main concern. If the area gets infected, action will need to be taken. When anal fissures and fistulas don’t heal properly on their own, or the condition keeps recurring, treatment will likely include:

Common Questions About Anal Fissures & Fistulas

#1: Can a Fissure Turn Into a Fistula?

While a fissure doesn’t directly turn into a fistula, a fissure has the potential to become infected and turn into an abscess. It’s unlikely that your fissure will become a fistula though, unless you ignore it and don’t seek treatment.

#2: How Do You Know If You Have a Fistula?

An anal fistula is a condition that lives under the skin, so it will be difficult (if not impossible) for you to diagnose this yourself. If you suspect, due to symptoms, that you might have an anal condition, get in touch with your doctor or a specialist right away.

#3: How Do You Heal an Anal Fissure?

Anal fissures can usually heal on their own with time and proper care (keeping the area clean and dry); however, some fissures just don’t heal on their own for a number of reasons (mainly due to defecation tearing the fissure open repeatedly). For these people, surgical options are best.

Repair Options at Suncoast Surgical Associates

Here at Suncoast Surgical Associates, we offer both LIS and anal fistulotomy for patients struggling with fissures and fistulas. If you live in the Tampa Bay area and have been struggling to heal your anal conditions (or they keep recurring), get in touch with our office or ask for a referral to one of our specialists from your doctor.


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