I will add my two cents in, but I may be wrong. I wouldn't think it's possible for a fistula to look like a hemorrhoid. By my logic :smile: a fistula channel may make it's way to the surface of the skin - if it cannot then drain out of the skin it would start collecting and cause an abscess, ie, the skin would bulge out over a larger area than the head of a hemorrhoid. Again - I can only judge by the look of the hemorrhoids I have seen over the last few years.