difference between piles and fissure and fistula

Know The Difference Between Piles, Fissures and Fistula

difference between piles and fissure and fistula

Anal and rectal conditions can be both painful and embarrassing, yet they are fairly common and often treatable. Understanding the difference between piles, fissures, and fistula is essential for proper diagnosis and treatment. While affecting similar body areas, these conditions have distinct causes, symptoms, and treatments. 

This article aims to clarify the difference between piles, fissures, and fistulas so that you can better understand them and seek appropriate medical advice. 

5 Key Differences Between Piles, Fissures, and Fistulas

  1. Nature of the Condition:

    • Piles:  When three bunches of blood vessels in the anal canal gets enlarged and bleeds.
    • Fissures: Small tears in the anal lining.
    • Fistulas: Abnormal connections between the bowel and the skin near the anus.
  2. Primary Symptoms:

    • Piles: Bleeding during bowel movements, itching, Swelling and discomfort.
    • Fissures: Sharp pain during bowel movements and a visible tear.
    • Fistulas: Persistent pain, swelling, and discharge of pus or blood.
  3. Causes:

    • Piles: Straining during bowel movements, chronic constipation, prolonged sitting, and pregnancy.
    • Fissures: Passing large or hard stools, chronic diarrhoea, and inflammatory bowel diseases
    • Fistulas: Often follow an abscess or infection in the anal glands.
  4. Treatment Methods:

    • Piles: medications, lifestyle changes, yoga, minimally invasive procedures or surgeries, depending on the stage of piles
    • Fissures: Dietary changes, stool softeners, topical anaesthetics, or surgery.
    • Fistulas: Generally require surgical intervention such as fistulotomy, seton placement, or laser treatment.
  5. Location and Impact:

    • Piles: Occur inside or around the anus and primarily cause bleeding and discomfort.
    • Fissures: Located at the anal opening and cause sharp pain and visible tears.
    • Fistulas: Form an abnormal passageway, often leading to infection and discharge from opening close to the anal canal or pimple-like swelling near anus.

What is Piles? 

There are three bunches of blood vessels in the anal canal. When they enlarge and bleed, they are called Piles. 

What are Some Causes of Piles? 

causes of piles

Piles develop due to increased pressure in the blood vessels in the lower rectum. Common causes and risk factors include: 

      • Chronic Constipation or Diarrhoea: Straining during bowel movements puts pressure on the rectal veins.
      • Prolonged Sitting: Sitting for long periods, especially on the toilet, can increase pressure on the veins in the anus and rectum.
      • Obesity: Excess body weight puts additional pressure on the pelvic veins.
      • Low-Fiber Diet: Low fibre can lead to hard stools and constipation, increasing the risk of piles.
      • Heavy Lifting: Repeated heavy lifting can strain the lower rectum.

What is Piles Laser Treatment? 

Laser treatment is a modern and minimally invasive option for treating piles. It involves using a laser to shrink the haemorrhoids by cutting off their blood supply. This procedure is known for its precision, minimal discomfort, and quick recovery time. Here’s an overview of the process: 

What’s the standard Procedure for Piles Laser Treatment? 

      • Preparation: The patient is prepared for the procedure, usually under local anaesthesia or sedation.
      • Laser Application: A laser fibre is inserted into the haemorrhoid tissue. The laser energy coagulates the blood vessels, cutting off the blood supply to the haemorrhoid and causing it to shrink.
      • Minimal Incisions: Unlike traditional surgery, laser treatment involves minimal cutting, resulting in less pain and quicker healing.

What are the Advantages of Piles Laser Treatment? 

      • Less Pain: Patients typically experience less post-operative pain compared to traditional hemorrhoidectomy.
      • Quick Recovery: The recovery period is shorter, allowing patients to return to normal activities sooner.
      • Reduced Bleeding: Laser treatment causes less bleeding during and after the procedure.
      • Minimal Risk of Infection: The precision of the laser reduces the risk of infection and complications.

What’s the Aftercare after Piles Laser Treatment? 

      • Dietary Changes: A high-fibre diet and increased fluid intake are recommended to prevent constipation and straining.
      • Pain Management: Over-the-counter pain relievers and warm sitz baths can help manage discomfort.
      • Follow-Up: Regular follow-up with the doctor to monitor healing and address concerns. 

(Know more about Piles Treatment)




What is a Fissure? 

An anal fissure is a small tear or cut in the lining of the anus, which can cause pain and bleeding during bowel movements. Fissures are common and can occur at any age. They often result from trauma to the anal canal, causing a split in the skin. 

What are Some Causes of Fissure? 

causes of fissure

Anal fissures are typically caused by trauma to the anal canal, which can occur due to: 

      • Passing Large or Hard Stools: Straining to pass large or hard stools is the most common cause of fissures.
      • Chronic Diarrhea: Frequent loose stools can irritate and tear the anal lining.
      • Chronic Constipation: Constipation and the resulting straining can cause fissures.
      • Straining During Bowel Movements: Excessive straining can lead to tears in the anal tissue.
      • Inflammatory Bowel Diseases: Conditions like Crohn’s disease can increase the risk of fissures due to inflammation of the bowel lining.

What are Some Symptoms of Fissure? 

The primary symptoms of an anal fissure include: 

      • Sharp Pain: The most common symptom is severe pain during bowel movements, which can continue for hours after the bowel movement.
      • Bright Red Blood: Blood on the stool or toilet paper is a typical sign of a fissure.
      • Visible Tear: A small tear or crack in the skin around the anus may be visible.
      • Itching and Irritation: The area around the anus may feel itchy or irritated.
      • A Small Lump or Skin Tag: A small lump or skin tag near the fissure can sometimes be felt.

What are Some Treatment for Fissure? 

Anal fissures can be quite painful and require proper management to heal effectively. Here are detailed explanations of various treatment options: 

      • Sitz Bath: A sitz bath involves sitting in warm water to relieve pain and promote healing of the anal fissure. This simple, non-invasive treatment can be done at home.
      • Simple Medication: Simple medications include over-the-counter and prescription drugs that help alleviate the symptoms of anal fissures and promote healing.
      • Dietary and lifestyle modifications: These are essential for both treating and preventing anal fissures. These changes focus on softening stools and ensuring regular bowel movements to avoid further trauma to the anal area.

Please note: Fissure usually resolves with medications and lifestyle changes, if it’s not associated with infection. 

(Know more about Fissure Laser Treatment) 

What is a Fistula? 

A fistula is an abnormal connection or passageway that forms between two organs or vessels that normally do not connect. In the context of the anal region, an anal fistula is an abnormal tunnel that develops between the inner lining of the anal canal and the skin near the anus. 

This condition is often the result of an infection in an anal gland that leads to the formation of an abscess which may later form a fistula. 

What are Some Causes of Fistula? 

causes of fistula

Anal fistulas are commonly caused by an infection that starts in an anal gland. The infection leads to an abscess that can form a fistula if not adequately treated. 

      • Anal Abscesses: The primary cause of fistulas. An abscess is a collection of pus that forms due to infection.
      • Crohn’s Disease: An inflammatory bowel disease that causes chronic inflammation of the gastrointestinal tract, which can lead to fistulas.
      • Radiation Therapy: Used to treat cancer, radiation can damage tissues and lead to the formation of fistulas.
      • Trauma: Physical injury to the anal region.
      • Sexually Transmitted Infections (STIs): Certain STIs can lead to infections that cause fistulas.
      • Tuberculosis: An infectious disease that can cause fistulas in rare cases.
      • Diverticulitis: Inflammation or infection of small pouches that can form in the walls of the digestive tract.

What are Some Symptoms of Fistula? 

The symptoms of an anal fistula can vary depending on the location and severity of the fistula. 

      • Pain and Swelling: Around the anus, which can be constant or intermittent.
      • Discharge: Pus or blood discharge from an opening near the anus. The discharge can cause irritation and a foul smell.
      • Recurrent Abscesses: Frequent abscess formation in the anal area.
      • Irritation of the Skin: Around the anus due to constant discharge.
      • Fever and Chills: In the abscess stage.
      • Painful Bowel Movements: Due to the presence of the fistula and associated inflammation.
      • Difficulty Sitting: Discomfort or pain while sitting.

What are some Treatments for Fistula? 

      • Fistula-in-Ano Surgery: Surgery is the line of treatment to treat fistulas.
      • Fistulotomy: Fistulotomy is one of the most common surgical procedures for treating anal fistulas. In this procedure, the surgeon cuts open the fistula tract along its entire length.
      • Fistulectomy: Fistulectomy is another surgical option for treating fistulas. This procedure involves the complete excision of the fistulous tract.
      • Laser ablation of fistula tract (LAFT): It is a minimally invasive surgical procedure used to treat fistula, an abnormal connection between two organs or tissues. In the case of LAFT, the fistula is between the anus and the skin around it.
      • Ksharasutra & Ksharakarma: Ksharasutra and Ksharakarma are traditional Ayurvedic treatments for fistula-in-ano. Ksharasutra involves the use of a medicated thread that is placed in the fistulous tract.

(Know more about Fistula Treatment) 


Understanding the difference between piles, fissures, and fistulas can significantly impact the approach to treatment and management. 

If you’re struggling with piles, fissures, or fistulas and want expert guidance on the best treatment options, look no further than Chirag Global Hospitals. Our team of experienced specialists is dedicated to providing comprehensive care tailored to your needs. Don’t let discomfort and pain control your life any longer. 

Contact Chirag Global Hospitals today and take the first step towards effective, compassionate treatment and a healthier, more comfortable life. 

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