Consult Super-Specialist Doctors at CARE Hospitals
Updated on 7 November 2023
Piles and fissures are anal pathologies which cause certain common symptoms like passing bloody stools or having trouble passing stools, itchy and irritable anal cavity, and discomfort when sitting for a long time, among other such symptoms.
The anus is the end orifice of the digestive tract through which excreta (stools) are expelled from the body. Piles and fissures are two of the common disorders concerning the anal region. Almost 20% of the Indian population suffers from piles and fissures. However, since both these disorders have very similar symptoms, it is important to understand the piles and fissures difference.
Piles, also known as haemorrhoids, is a condition of the anus in which the veins in the terminal part of the anus get swollen. Piles primarily affect the population over 50 but are common in pregnant women. In most cases, piles may begin to heal on their own before the symptoms appear.
Piles can be broadly classified into three categories:
The symptoms of piles may include:
The symptoms of piles and the treatment would depend upon the type of piles present in the affected individual and their severity.
Most of the time, piles can get better on their own within a few days. There can be occasional itchiness, pain, and passing blood along with stool. However, it can become a serious problem if there is:
Chronic constipation and difficulty in bowel movements cause piles. There can be other reasons that may lead to piles. These include the following:
Piles tend to get better on their own if they're in their initial stages. Sometimes, it is possible to treat piles with simple lifestyle changes and treatments such as:
If non-interventional treatment for piles doesn't work, surgical treatments such as banding, infrared coagulation, sclerotherapy, and haemorrhoidectomy may help fix this problem.
Fissures are tears in the moist tissue of the anal region, which causes painful spasms and itching in the anal region. The basic difference between anus fissure and piles is that, unlike piles, the pain in the anal region can be present from the beginning of the problem. Fissures can be categorised into two types depending on the severity of the condition:
Fissures can be treated by medications or by making dietary changes by adding more fibre to the diet and drinking more water, especially in the morning on an empty stomach, to help empty the bowels more smoothly. If the problem persists for more than a week, it is best to consult a doctor.
The symptoms of fissures are usually present from the beginning of the problem due to anal tearing with ensuing pain. There can be additional symptoms of fissures, which may include the following:
Anal tears causing anal fissures may be caused by a variety of reasons which may include the following:
Some of the lesser common yet possible causes of anal fissures may include the following:
Fistulas are another condition affecting the anal region. The anal glands present in the middle portion of the anus may get infected, leading to an anal abscess. This can cause pus to start oozing out and create a passage, called a fistula, to the infected gland; a fistula has been associated with being overweight and sitting for a prolonged duration of time. There can be pain, swelling, redness, and release of pus.
The difference between piles and fissures and fistula is in the affected region, i.e. in fistulas, the anal glands are affected, but in piles and fissures, any place in the anal region can be affected. Anal fistulas can be treated with antibiotics.
Anal fistulas are caused by a blockage in the passage of fluids in the fluid glands in the anus leading to the creation of pus-filled abscesses. Such blockage leads to the growth of bacteria that create pockets in the abscesses. If left untreated, these abscesses may grow and push out of the anus to drain the pus. In most cases, these abscesses become fistulas.
Anal fistulas may also be caused due to diseases such as tuberculosis and due to certain sexually transmitted diseases.
Anal fistulas may cause a number of symptoms which may include the following:
It is advisable to visit a doctor if symptoms of fever occur along with pain and bleeding.
There are quite a few differences between piles, fissures, and fistulas in their area of occurrence, symptoms, and other features.
Piles |
Fissure |
Fistula |
|
Area of occurrence |
Above the orifice of the anus (internal piles) or outside the edge of the anus (external piles) |
Lining of the anal canal |
From the upper part of the anal gland inside the anal passage to the anal skin outside |
Causes |
|
|
|
Symptoms |
|
|
|
Treatment |
Non-surgical: Eating high fibre foods, taking pain relieving medications, and topical treatments. Surgical: Sclerotherapy, coagulation technique, and rubber band ligation. |
Non-surgical: High fibre diet, medications, and hydrating frequently. Surgical: Lateral internal sphincterectomy. |
Non-surgical: Medications. Surgical: Fistulotomy (simple fistula surgery) , Seton drain, endorectal advancement flap, LIFT (ligation of intersphincteric fistula tract). |
All three conditions can be significantly improved or even prevented by taking a fiber-rich diet and intake of more fluids. Additionally, fistulas can be prevented by taking care of hygiene.
Anal bleeding and pain, especially when passing stool, is a primary indicator of such problems, particularly in obese people and those over the age of 50. Piles, fissures, and fistulas should not be left untreated, as these may lead to chronic conditions and unexpected complications. While these problems are common, very few people seek help due to embarrassment.
It is important to remember that these can be easily treated with minimal intervention and even without any surgery. So, do not be embarrassed to ask for help. The top gastroenterologists at CARE Hospitals treat such conditions with utmost expertise and confidentiality.
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