Whether blood during bowel movements is caused by hemorrhoids or anal fissures depends on the amount of bleeding and the accompanying symptoms. Bleeding from hemorrhoids is caused by internal hemorrhoids, which are accompanied by the prolapse of the anal swelling during defecation, and the bleeding is characterized by painless, intermittent post-poo dripping, or in severe cases, jet bleeding, so the amount of bleeding is mostly excessive. In the case of anal fissure bleeding, the amount of bleeding is small, and some of them only show blood on hand paper. When the fissure damages small local blood vessels, it may cause more bleeding, but the fissure can be seen at the edge of the anus, and the blood in the stool of anal fissure is accompanied by painful tearing sensation in the anus during defecation or periodic pain.