Difference between Piles, Fissure and Fistula

The anal tract contains many significant veins. The blood flow to the anus can get interrupted due to chronic constipation, straining while passing stools, pregnancy or obesity, which can cause the swelling of the veins. These swellings are called piles or haemorrhoids. Piles may be of two types:

1. Internal Haemorrhoids- They form in the lower rectum and occasionally protrude from the anus.
2. External Haemorrhoids- They appear on the skin surrounding the anus. In case a blood clot forms in an external pile, a hard lump develops around the anus.

There is increased pressure in the lower rectum, causing piles that can be brought on by: 

1. Straining excessively during bowel movements
2. Sitting on the toilet for long
3. Persistent Diarrhoea or Constipation.
4. Obesity
5. Pregnancy
6. Anal intercourse
7. Eating a low-fibre diet
8. Repetitive heavy lifting

Linear tear in the anal mucosa is called an anal fissure. Chronic anal fissure persist for more than four to eight weeks. Bowel movements become difficult when one has chronic constipation. While passing hard stool, the mucous layer around the anus could be torn or ripped. Anal fissure are more common in children than in adults. Reduced blood flow to the anal canal muscles or Crohn’s disease (a disease that causes swelling and irritation of the digestive tract) can also cause fissure in adults. The following factors may contribute to the trauma: 

1. Constipation that persists over time
2. Struggling to go to the bathroom, mainly if the stool is hard or dry
3. Persistent diarrhoea
4. Anal stretching
5. Anal sex 
6. Insertion of foreign objects into the anus

Faecal matter can block the tiny glands in the anus and cause infection. It results in an abscess formation (pus collection). If the pus from the abscess does not drain properly, a fistula (an abnormal connection between two parts of the body) can form. Anal abscesses and clogged anal glands are the leading causes of an Anal Fistula. Other, considerably less frequent diseases that might result in an anal fistula are:

1. Trauma
2. Crohn's disease (an inflammatory illness of the gut)
3. Infections caused by sexual contact
4. Cancer
5. Diverticulitis causes tiny pouches to grow in the big intestine and become inflamed
6. Tuberculosis

The three medical conditions known as fissure, piles, and fistula appear identical at first glance. But if they are looked at closely, the difference between piles, fissure, and fistula is significant. The following are the primary distinctions between piles, fistula, and fissure:

1. Blood vessels in the anal canal are affected by piles.
2. The fistula is the tunnel between the anus and the surrounding skin that is infected.
3. A fissure is a painful crack on the anal tissue's lining.

You can differentiate between piles, fissure, and fistula with the help of the information given below:

1. Most piles are painless and unnoticeable. Fissure is much more painful. The fistula leaks pus out of the anal region and is quite painful.
2. In addition to constipation, commonly associated with all three, piles are linked to pregnancy. Fissure is associated with straining while passing stools and diarrhoea. Fistula is commonly caused by Crohn’s disease, obesity, and prolonged sitting. 
3. By eating a high-fibre diet and drinking more fluids can prevent all three. Furthermore, by practising better toilet hygiene practices, one can prevent fistula.
4. Over-the-counter medications and home remedies can be used to treat piles. A Lateral Sphincterotomy Surgery and medication may be necessary to treat fissure. It is much more difficult to detect and treat fistula; it may be necessary to perform a Magnetic Resonance Imaging (MRI) scan or sonofistulagram to determine their passage. Video-assisted Anal Fistula treatment and other approaches like Laser Surgery are used to treat them.

Piles are swollen blood vessels in the rectum, a fistula is when the anal region and the skin form an irregular canal, and fissure are cut in the anal lining. Therefore, the common symptoms of piles, fissure and fistula are:

It is always advisable to see a doctor if you experience bleeding, pain, or drainage from the anus. These are issues that are typically simple to identify and address. To treat these disorders, several procedures are available, including surgery.

Piles, fissure and fistula are anorectal disorders. Various factors can cause piles, fissure and fistula. A few factors that help to understand the difference between causes of piles, fissure and fistula are:

It is crucial to know the cause and consult your nearest doctor for immediate treatment if any symptoms are caused by anal disorders. 

Some interesting facts about Piles, Fissure and Fistula are:

1. 75 per cent of the population is affected with piles by age 50.
2. Piles is most common during pregnancy.
3. The anus can occasionally clog due to blood resulting in external haemorrhoids.
4. With the help of medication and a diet high in fibre, an acute fissure is easily treatable.
5. Chronic fissure can recur and is challenging to manage.
6. Fistula might be linked to obesity and spending a lot of time sitting still.
7. The fistula can appear as an oozing pus-filled large, painful, and red opening.
8. Antibiotics can be used to treat a fistula.

The anal canal is affected by piles, fissure and fistula. It is important to remember that these issues are not related to the same illness. These illnesses each have different locations and degrees of intensity where they have an impact on the human body. Every symptom must be carefully examined, and then treatment should be sought if necessary. Consult a doctor as soon as possible if you have piles, fissure, or fistula.

At HexaHealth, we provide the best care and zero-cost surgery assistance. We take care of Hospital admissions, insurance claims, and other paperwork at zero cost. We do corrective Minimally Invasive Surgeries for various conditions, including Laser and Stapler Surgeries for Piles, Fissure, and Fistula. Our team of 1500+ doctors is there to guide you every step of the way!