Anal fissures are small tears in the lining of the anal canal, while hemorrhoids are dilated blood vessels that occur both inside the rectum as well as outside. Internal hemorrhoids typically present with itching, pressure or bleeding, while external hemorrhoids typically present with pain and swelling. Occasionally, internal hemorrhoids can prolapse or push to the outside. This typically occurs with more severe hemorrhoidal disease. Internal and external hemorrhoids can be treated with medication. If this is ineffective, we perform a procedure called hemorrhoidal banding here at GIS to disrupt the blood flow to the hemorrhoid and create a scar tissue in its place. It's extremely effective to manage internal hemorrhoids. If all else fails, hemorrhoids can be managed surgically.