Many people experience discomfort related to anal and rectal conditions but struggle to identify the exact issue. Piles, fissures, and fistulas are common anorectal problems that share some symptoms but have different causes and treatments. Understanding the differences can help in seeking timely medical care and avoiding complications.

In this blog, our doctors at Vedam Gastro Hospital, one of the best gastro hospitals in Surat, explore piles, fissures, and fistulas, their causes, symptoms, and treatment options.

What Are Piles, Fissures, and Fistulas?

Piles (hemorrhoids), fissures, and fistulas are different medical conditions that affect the anal and rectal region. Though they cause discomfort and pain, they have distinct causes and treatments.

• Piles (Hemorrhoids): Swollen veins in the rectum or anus caused by excessive pressure.
• Anal Fissure: A small tear or crack in the lining of the anus, leading to pain and bleeding.
• Anal Fistula: An abnormal tunnel between the anal canal and the surrounding skin, usually caused by infection.

Piles (Hemorrhoids)

Causes of Piles

Piles develop due to increased pressure in the lower rectum. Our gastrosurgeons in Surat list the common causes as:

● Chronic constipation or straining during bowel movements

● Prolonged sitting, especially on the toilet

● Pregnancy and childbirth

● Obesity and lack of physical activity

● Low-fiber diet leading to hard stools

Symptoms of Piles

Piles can be internal or external and cause different symptoms:

● Internal Piles: Located inside the rectum, usually painless but may cause bleeding.

● External Piles: Located under the skin around the anus, leading to pain, swelling, itching, and discomfort.

Other symptoms include:

● Bright red blood during bowel movements

● A lump or swelling around the anus

● Mucus discharge after passing stool

● Persistent itching and irritation

Treatment for Piles

Mild cases improve with lifestyle changes, while severe cases may require medical intervention from a stomach hospital in Surat.

● Home Remedies: High-fiber diet, drinking plenty of water, and avoiding straining during bowel movements.

● Medications: Over-the-counter creams, ointments, and pain relievers to reduce swelling and discomfort.

● Minimally Invasive Procedures: Rubber band ligation, sclerotherapy, and infrared coagulation to shrink hemorrhoids.

● Surgery: Hemorrhoidectomy or stapled hemorrhoidopexy for severe cases.

Anal Fissures

Causes of Anal Fissures

Anal fissures occur when the anal lining tears due to:

● Passing hard or large stools

● Chronic constipation or diarrhea

● Straining during childbirth

● Inflammatory bowel diseases (Crohn’s disease)

Symptoms of Anal Fissures

Anal fissures cause sharp pain and discomfort, especially during and after bowel movements. Common symptoms include:

● Intense pain while passing stools

● Bright red blood on toilet paper or stool

● A visible tear near the anus

● A small lump or skin tag near the fissure

● Burning sensation or itching in the anal area

Treatment for Anal Fissures

Most fissures heal within a few weeks with proper care, but chronic fissures may need medical treatment.

● Home Remedies: High-fiber diet, stool softeners, and warm sitz baths to relax the anal muscles.

● Medications: Topical creams (nitrate or calcium channel blockers) to improve blood flow and heal the fissure.

● Botox Injections: Help relax the anal sphincter and promote healing.

● Surgery (Lateral Internal Sphincterotomy): Recommended for chronic fissures that do not heal with other treatments.

Anal Fistulas

Causes of Anal Fistulas

An anal fistula develops when an abscess (pus-filled cavity) forms inside the anus due to infection. The pus drains through an abnormal tunnel connecting the anal canal to the skin. Common causes include:

● Untreated anal abscesses

● Chronic infections in the anal glands

● Crohn’s disease or other inflammatory bowel diseases

● Tuberculosis or sexually transmitted infections (rare)

Symptoms of Anal Fistulas

Unlike piles and fissures, an anal fistula does not heal on its own and requires medical treatment. Symptoms include:

● Persistent pain and swelling near the anus

● Pus or foul-smelling discharge from the opening near the anus

● Recurrent anal abscesses

● Difficulty sitting or moving due to pain

● Fever and fatigue (in severe cases)

Treatment for Anal Fistulas

Since fistulas do not heal naturally, the best colorectal surgeons in Surat advise surgery as the primary treatment option.

● Antibiotics: Help control infection before surgery.

● Fistulotomy: A surgical procedure to open and drain the fistula tract.

● Seton Placement: A small surgical thread inserted into the fistula to promote gradual healing.

● Advancement Flap Surgery: Used for complex fistulas, where healthy tissue is used to close the fistula opening.

Key Differences Between Piles, Fissures, and Fistulas

When to See a Doctor?

Seek medical attention if you experience:

● Persistent pain or bleeding during bowel movements

● Recurring lumps or swelling near the anus

● Pus or foul-smelling discharge

● Difficulty sitting due to severe pain

● Symptoms that do not improve with home remedies

Early diagnosis and treatment can prevent complications and improve recovery.

Conclusion

Piles, fissures, and fistulas are common but distinct anorectal conditions. While piles involve swollen veins, fissures are tears in the anal lining, and fistulas result from infections forming abnormal tunnels. Each condition requires specific treatment, ranging from home remedies and medications to surgical procedures.

If you experience any of these symptoms, consult a doctor for a proper diagnosis and treatment plan. Early intervention ensures faster recovery and prevents further complications.