Although hemorrhoids and anal fissures are two different conditions, they are commonly mistaken as the same due to their similarities of symptoms and treatments. Hemorrhoids occur when the veins in the anal region become enlarged or swollen. An anal fissure, on the other hand, is a small tear in the anal lining, this is also known as the anoderm. Although hemorrhoids can lead to tears in the anoderm, tears in the anoderm do not need to be present in order for one to be diagnosed with hemorrhoids, whereas in an anal fissure, an actual tear needs to be present.