Rectal Hemmorrhoids and Rectal Fissures Hemmorrhoids are classified into external and internal depending if they are external to the sphincter or internal to the rectal sphincter. Hemmorrhoids are varicose veins in the rectal area. They are usually caused by long time difficult bowel movements and also in women with child bearing. Fissures are small cracks in the skin at the rectum that are usually caused by large hard stools during bowel movments. Treatment is usually with Anusol cream or suppositories and sitz baths.