What is the difference between Piles, Fissures and Anal Fistula?

difference between Piles, Fissures and Anal Fistula

If you experience pain and see blood while passing stools, it may not necessarily be piles as you believe it to be. That is because Piles are one of the many conditions that affect the anal region. Pain or bleeding from the anal region may also indicate anal fistula or fissures.

Let us individually look at the three conditions:

  • Piles


Piles refer to the condition of swollen blood vessels in the anal canal. They usually occur when a person suffers from chronic constipation and difficulty in passing of stool due to poor diet/smoking / bad genetics.

Symptoms: Piles are initially painless, while they bleed like drops. Although initially there may not be swelling, it is experienced in the second and third stage, with the pain becoming extremely severe in the fourth stage due to clotting of blood.

Treatment: Piles in early stages require medications, good high fibre diet with plenty of liquids to prevent constipation and straining; rather than the need to operate. However, the need to operate piles arises in the third stage and beyond. Today, there are many improved techniques such as MIPH (Minimally Invasive Procedure for Haemorrhoids) which considerably decrease pain and enable quick recovery with shorter hospital stays.

Prevention: Piles can be prevented with high fibre diets with plenty of liquids. Consult a doctor immediately and get treated if you are having constipation. Do not exert too much pressure while passing stools.


  • Anal Fistula

Anal Fistula

Fistulas occur due to the bursting of an infected anal gland into the anal canal internally. It then becomes a tunnel for pus discharge to the anal skin area.

Symptom: Fistulas appear with pus discharge in the anal area, making the person feel wet in the anal area. There may be times when there are pus discharge and times when there are no symptoms.

Treatment:  It is important to note that fistula can take the varied path and hence image such as an ultrasound scan (sonofistulogram) or an MRI will help define the path a surgeon should take to treat it correctly. New methods such as VAAFT or video-assisted anal fistula treatment—a daycare surgery—wherein a camera is used to identify the track internally to destroy it with electric current and seal it with staples and glue. However, it is necessary to estimate if the given fistula is best treated with open conventional surgery or VAAFT.

Prevention:  Fistulas can be prevented with proper hygienic toilet habits which can stop infections in the anal canals.


  • Anal Fissures

Anal Fissures

A very common problem that occurs at least once, in a lifetime, fissure are cracks in the skin of the anal canal.

Symptoms:  Anal fissures hurt a lot, where the person may feel like avoiding washroom visits. Bleeding is infrequent in the fissure and maybe just a streak on the stool.

Treatment:  The preferred procedure anal fissures’ treatment is a Lateral Sphincterotomy, which gives immediate relief from pain and is done as a daycare procedure. However, surgery isn’t required for most fissures; an option only when fissures are recurrent. Fissure are treated with medications, good high fibre diet and plenty of liquids.

Prevention: A good high fibre diet with plenty of liquids is the best way to prevent anal fissures.

2018-02-28 11:42:57 manasee@eyecatchers.co