Difference Between Piles, Fissure and Fistula

Difference Between Piles, Fissure and Fistula

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    The anus is the lowermost part of the body and is also called “the exit for the stools”. It passes through the strong, muscular canal of the pelvic and anal sphincter. The canal is around 5-6 cm long. We know defects in the anal canal are known as anal disorders, and piles, fissures, and fistula are some of the most common anal diseases. 

    Many people think that there is no difference between piles, fissure and fistula and that they are just synonyms. Well, that’s not true. 

    Let’s understand the difference between piles fissure and fistula but first, let’s learn more about them individually:


    What Is Piles Disease?

    Pile is a disease caused by the swollen, sensitive nerves at the ending of the anus canal and is also known as haemorrhoids.

    Some facts about piles:

    ● Found commonly in people aged 50 or above. 

    ● Widely observed in pregnant women.

    ● Haemorrhoids can be both internal & external.

    ● Bleeding may occur.

    ● Occasionally blood may thicken, resulting in external haemorrhoids.

    ● Occur because of chronic constipation and difficult bowel actions.

    Are Piles Risky?

    Piles are not that serious at the initial stages until they swell up. The swollen part can result in chronic constipation and harden the bowel movement. 

    Let’s have a look at some of the common symptoms of piles.

    ● Painful inflammation around the rectum

    ● A sensation of full bowels even after excretion of stool

    ● Rosy red blood after every bowel movement

    ● Itchiness, bleeding, swelling in the anus

    ● Discomfort during the passage of stool

    Piles become serious when these symptoms can be observed. 

    ● Anal bleeding leading to anaemia

    ● Faecal incontinence

    ● Anal fistula

    ● Blood clot or infection due to strangulated haemorrhoid

    Causes of piles

    Piles can be a result of increased pressure in the lower rectum, among other reasons like-

    ● Constant constipation

    ● Incessant diarrhoea

    ● Lifting heavyweights 

    ● Pregnancy

    ● Stressing while passing stool

    Are Piles Curable?

    In almost every case, piles just go away on their own. Some treatments such as laxatives and topical corticosteroids also work well in treating piles. Your doctor can prescribe surgical treatments such as banding, sclerotherapy and infrared coagulation, depending on the condition. 


    Fissures are like small drop-like structures at the lining of the anal canal. Fissures can be formed by passing hard or large stools. 

    Some facts about fissures:

    ● It generally occurs when a person extends and pressurises a lot to defecate.

    ● It may be possible that a person may ooze blood or pus if infected with a fissure.

    ● Fissure can happen due to constipation, chronic diarrhoea, and enormous exercise.

    ● It may introduce acute and incurable aspects.

    ● An acute fissure can be effortlessly remedied with a fibre-rich diet and treatment.

    ● Chronic is tough to regulate and can recur.

    How To Know If You Have Anal Fissures?

    Here are some symptoms of anal fissures:

    ● Extreme pain during bowel movements

    ● Pain that pertains after bowel movements, for several hours

    ● Rosy red blood appears after bowel movements

    ● Inflammation of skin label near anal fissure

    Only after you read about the two conditions do you realise the diff between piles and fissure!

    What Can Cause Anal Fissures?

    Here are some common cause behind anal fissures:

    ● It can be caused by defecating large or hard stools

    ● Stretching during bowel movements

    ● Continual diarrhoea

    ● It can be caused due to anal intercourse

    ● During childbirth

    Some other less common reasons for anal fissures are:

    ● Crohn’s disease

    ● Anal cancer

    ● HIV

    ● Syphilis

    ● Tuberculosis

    Are There Any Complications For Anal Fissures?

    There are some chances where anal fissures become severe and lead to complications. They may lengthen to the surrounding muscles, making them tough to recover. If fissures fail to heal in eight weeks, then additional medication or procedures are needed. 

    Here is some information about fistulas that will help you identify the diff between fissure and fistula:


    Fistulas are an infected connection between the anus and the skin. They are the passage connecting the infected gland to the abscess. The anal glands (in the middle of the anus) may get affected, which leads to inflammation or results in ulcers or sores inside the intestine and the nearby organs and causes the pus to ooze out from the infected region. The collection of pus (abscess) can also cause fistulas. 

    Some quick facts

    ● Anal fistulas result from radiation cancer, trauma, Crohn’s disease, warts, et al.

    ● Prolonged hours of sitting and obesity can also lead to the formation of fistulas. 

    ● They are an abnormal connection between two body parts and are presented as a swollen, painful opening with pus oozing out from the infected area.

    What Are Anal Fistulas Caused By?

    Usually, an anal fistula is caused when the glands responsible for providing fluids to nearby parts or organs are blocked. Due to the lack of moisture, bacteria start to grow in those areas creating abscesses (or pockets). If not treated, these abscesses may grow out and move outside the anal opening to drain out. Now, these abscesses may turn into anal fistulas, in most cases. Fistulas are also caused due to conditions like tuberculosis or sexually transmitted diseases such as AIDS, Syphilis, Herpes, etc.

    How To Identify Anal Fistulas?

    Anal fistulas show specific symptoms that you need to keep an eye on. Common symptoms such as chronic pain, redness, painful bowel movement, inflammation around the anus, bleeding, fever, etc., are a way to identify anal fistulas. In these cases, it’s highly recommended to visit a doctor, or it might lead to serious conditions later down the line. Do not get confused between fissures and fistulas. Though they might seem alike, there are clear differences between fistula and fissure. 

    Is It Possible To Diagnose Anal Fistulas?

    Of course, it is. However, some fistulas can be easily diagnosed, and others may not. Your doctor can diagnose an anal fistula after a physical analysis. They may check for oozing pus or bleeding from the anal region. They may also ask you to visit specialist doctors for rectal or colon conditions. You will need to undergo specific tests, such as CT scans or X-rays. 

     What Is The Main Difference Between Piles And Fissure? 

    The most apparent difference between piles and fissure is that fissures are observed in patients with diarrhoea or constipation. In contrast, piles are associated with people with a constant cough and are observed in pregnant women. Another difference between piles and fissure is their treatments. Piles can be treated via over-the-counter medicines, but for fissures, your doctor may recommend procedures like lateral sphincterotomy. Also, piles can be cured even before indications symptoms start to occur, and this is not the case with fissures, leading to another vital difference between piles and fissure. 

    What Is The Difference Between Fistula And Fissure? 

    There is not much diff between fissure and fistula, and a consultation with your primary care provider is vital to diagnose the problem. Fistulas are primarily seen in patients with Crohn’s disease and observed in people who sit in one place for a long time and are obese. They can be prevented by practising good defecation hygiene. 

    While the diff between fissure and piles is to follow, the difference between fistula and fissures is a little challenging to comprehend.

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