Haemorrhoids are found in the upper anal canal where there are no nerves that sense pain. Anal fissures occur at the outer edge of the anus which senses sharp pain. Therefore, anal fissures tend to cause sharp pain when you pass stools. It tend to cause painless fresh bleeding when you pass stools.
Sometimes, it is difficult to differentiate the two conditions because both can cause fresh bleeding during the passage of stools.
Anal fissures will usually cause pain and the amount of bleeding is small (seen as streaks of blood when wiping the anus with toilet tissue). Haemorrhoids tend to cause more bleeding, which may be seen on toilet tissue or even drips into the toilet bowl.
Some patients with haemorrhoids may feel a lump protrude out of the anus when they clean the anus.
