What is the Difference Between Fissure and Fistula

The main difference between fissure and fistula is that fissure is a tear near the skin of the anus whereas a fistula is an infected tunnel between the skin and the anus.

Fissure and fistula are two complications that occur near the anus. They result in symptoms such as itchiness or pain and bleeding in the rectal area.

Key Areas Covered

1. What is Fissure
   • Definition, Characteristics, Importance
2. What is Fistula
   • Definition, Characteristics, Importance
3. Similarities Between Fissure and Fistula
   • Outline of Common Features
4. Difference Between Fissure and Fistula
   • Comparison of Key Differences

Key Terms

Fissure, Fistula

What is Fissure

A fissure is a tear in the outer layer of tissues of the anal canal. The squamous epithelial cells generally form the outermost tissue layer of the anal canal. Pain and bleeding are common symptoms that can occur in fissures. A physical examination can usually diagnose a fissure, the presence of a tear in the posterior or the anterior part of the anal canal. There are three common causes of fissures: inflammatory bowel disease, straining during defecation, and difficult childbirth.

Figure 1: Fissure

Furthermore, the risk factors for developing fissures include straining during defecation due to constipation and having difficult childbirth. On the other hand, different ointments can treat fissures, and sitz baths for 10 minutes can also prove helpful. Stool softeners are another option to prevent straining during defecation.

What is Fistula

The fistula is some type of connection between two regions that should not be present. It can generally occur in the middle region of the skin of the anal canal. Bad-smelling discharge is one of the common symptoms of fistula. The more common regions where fistula occurs are between the anus and the skin and the vagina and the rectum. Pain and foul-smelling discharge can occur in a fistula.

Figure 2: Fistula

Moreover, a physical examination or CT scan is important in the diagnosis of the fistula. In addition, the rectovaginal fistula results in the passage of feces into the vagina. Various inflammatory bowel diseases, Crohn’s disease, and difficult childbirth are the common causes of fistula. 

Similarities Between Fissure and Fistula

• Fissures and fistula are two complications that occur near the anus.
• Both cause symptoms such as itchiness or pain and bleeding in the rectal area.
• A medical professional can distinguish between the two and treat them.
• Both can occur in difficult childbirth.

Difference Between Fissure and Fistula

Definition

Fissure refers to a tear in the epithelial tissue near the anal canal while fistula refers to a connection created between the vagina and rectum or anus and the skin.

Symptoms

Usually, fissures can cause pain when defecting and bleeding while fistulas can cause pain and foul-smelling discharge.

Causes

Fissures can occur in inflammatory bowel disease, straining during defecation due to constipation, and difficult childbirth, while fistula occurs in inflammatory bowel problems, Crohn’s disease, and difficult childbirth.

Treatments

Ointments can treat fissures while surgery can treat fistula.

Prevention

It is important to treat constipation and inflammatory bowel disease in preventing fissures while treating inflammatory bowel disease and Crohn’s disease is important in preventing fistula.

Conclusion

In brief, fissure and fistula are two complications that can occur near the anus. A fissure is a tear in the epithelial tissue near the anus. In contrast, a fistula is a connection created between organs. However, pain and bleeding are the common symptoms of both fissure and fistula. Fissure can occur due to inflammatory bowel disease and difficult childbirth while fistula occurs due to inflammatory bowel disease and Crohn’s disease. However, the main difference between fissure and fistula is the type of complications.

References:

1. “Anal Fissure.” NHS Choices, NHS.
2. “Anal Fistula.” NHS Choices, NHS.

Image Courtesy:

1. “Ulcers, fissures, and erosions” By Madhero88 – Own work (CC BY SA 3.0) via Commons Wikimedia
2. “Fistula diag es 02” By McortNGHH – Own Work (CC BY-SA 4.0) via Commons Wikimedia