Anal fissures and hemorrhoids can indeed be easily confused in clinical practice. Because both occur in the same area and both present with symptoms of rectal bleeding and pain. However, these are two different diseases with different manifestations. Firstly, their symptoms differ. Anal fissures primarily cause severe pain in the anal area, which can feel like being cut with a knife. Hemorrhoids involve the prolapse of hemorrhoidal tissues, which can be felt with the hand and are more intuitively sensed. Their early signs also differ. Hemorrhoids generally start with bleeding without pain, while anal fissures typically start with pain and occasionally bleeding. In clinical practice, a local examination of the anal area is necessary to differentiate between them. By identifying their differences, a clear diagnosis can be made, and timely treatment can be provided to help patients recover health as soon as possible.