The difference between anal fissure bleeding and hemorrhoid bleeding is whether it is accompanied by pain, whether it is accompanied by constipation and the amount of bleeding, as follows: 1. Whether it is accompanied by pain: Anal fissure bleeding will be accompanied by severe pain, after defecation, the patient will have a sharp pain around the anus, pain often lasts 0.5-1 hours, and some even last a day, until the anal sphincter fatigue pain can be relieved. 2. The most common cause of bleeding hemorrhoids is internal hemorrhoids, which are not accompanied by pain and are painless. 2.