Piles vs. Fissures vs. Fistula

The major difference between piles, fissures, and fistula is that piles are the dilated inflamed veins in the lower region of the anal canal, fissures are termed as any cut or tear in the skin while any small opening which is developed abnormally in the skin is termed as fistula.

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Piles vs. Fissures vs. Fistula

Pile is a term specifically related to anal canal while fissures and fistula may be present anywhere in the body. However, in this article, we will  discuss anal fissures and fistula. Pile is also known as hemorrhoids. These are in fact dilated inflamed veins in the lower part of the anal canal. Anal fissures are small cuts or tears around the anus. They are very painful. While any abnormal small opening around the anus in the skin is called fistula. Mostly, it contains pus in it. Mostly, people consider piles, fissures, and fistula the same thing but they are different entities.

In the case of piles, initially, the patient is not aware of them because they are painless at the initial stage. But later, they are swollen, and pain is felt in the lower anal canal region. Fissures are very painful even at the initial stages. Pain is so severe that the patient starts avoiding toilet. The pain in case of fistula is even more than the other two conditions. In case of piles, bleeding occurs before or after passing the stools or blood comes out in the form of streaks around the stools. Blood is never mixed with stools. In the case of fissures, bleeding is infrequent. In the case of fistula, bleeding may occur, but most commonly, pus is discharged.

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The causes of piles include chronic constipation, pregnancy, chronic cough, liver cirrhosis and any other condition which increases the intraabdominal pressure. The causes of fissures include pregnancy, chronic constipation, homosexuality in males, Chron’s disease and any condition that exerts pressure to the anus. The causes of fistula include obesity, chron’s disease, prolonged constipation and prolonged sitting at one place.

Both piles and anal fissures can be avoided by taking high fiber diet and adequate liquid intake to correct the GIT function because the most common cause of both of these pathologies is constipation. Patients are said avoiding to exert too much pressure while straining. Fistula can be avoided by taking adequate care of hygiene, specifically while using the toilet. Because it is an infectious disease. So care of hygiene prevents infection. Proctoscopy is done for the examination of piles. Fissures and fistula are examined by naked eye externally.

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The treatment of the pile is to take high fiber diet and adequate liquids. Medicines are also given. For internal piles, rubber band ligation or hemorrhoidectomy is done. For the treatment of fissures, high fiber diet and medicines are recommended at the initial stages. Mostly they heal after one or two weeks. Botox injections are also given to relax the sphincters.  If not corrected, a surgical procedure is done known as lateral sphincterotomy. For the treatment of fistula, pus is drained, and antibiotics are given. VAAFT is done as a surgical option.

Comparison Chart

Basis Piles Fissures Fistula
Definition Piles are the dilated inflamed veins in the lower
part of the anal canal.
Anal fissures are the small cuts or tears in the
skin around the anal canal.
A fistula is abnormal small openings
or area of abscess in the skin around the anus.
Symptoms related to pain Pain is not felt at the initial stages, but later they become very painful.Severe pain is felt even in the initial stages. Pain
is very severe while passing stools.
A fistula is also very painful and prevents the person from straining.
Blood or pus discharge Blood is passed either before or after straining.
Blood is not mixed with the stools either it can pass in the form of a streak
besides the stools.
Blood is usually not passed with feces.Blood is usually not passed rather pus is often
discharged.
Underlying causes Chronic cough, chronic constipation, pregnancy or
any other condition that increases the intraabdominal
pressure.
Chronic cough, pregnancy, chron’s disease,
homosexuality in males and any condition that exerts pressure to the anal
canal.
Obesity, poor hygiene. Chrons disease, prolonged sitting
for a longer period of time, constipation.
Types They are of two types, i.e., internal hemorrhoids
and external hemorrhoids
They do not have further subtypes.They do not have further subtypes.
Prevention They can be prevented by taking high fiber diet, adequate liquids and avoiding
pressure while straining.
They can be prevented by taking high fiber diet, adequate liquid and maintaining
good hygiene.
They can be prevented by taking care of hygiene
during using the toilet because it is
an infectious disease.
Examined by They are examined by proctoscopy.They are examined by naked eye externally.They are examined by naked eye externally.
Treatment They are treated by rubber band ligation or hemorrhoidectomy.Mostly they heal after 2 weeks. Botox injection can
be given to relax the sphincter. If not healed, a lateral sphincterotomy is performed.
Pus is drained, and
antibiotics are given. VAAFT is done as a surgical option.

What are Piles?

Piles or hemorrhoids are very common nowadays. They are in fact dilated veins which are swollen also in the lower part of the anal canal. There may be many causes for them like pregnancy, obesity, low fiber diet, chronic cough, constipation, etc. Any condition which increases intraabdominal pressure may cause piles. They can be prevented by using a high fiber diet and adequate
liquid. The treatment is band ligation or hemorrhoidectomy.

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What are Fissures?

Fissures are cuts or small tears in the skin around the anus. They are also caused by the conditions which raise the intraabdominal pressure, but one important cause is homosexuality among males. Anal fissures are very painful, and the affected person is afraid of passing stools. Botox injection is given for relaxing the sphincters. Lateral sphincterotomy is also done as a surgical option.

What is Fistula?

A fistula is defined as an abnormally small opening in the skin around anus or areas of the abscess.  The most common cause of fistula formation is poor hygiene because they occur due to infection. They are very painful. Drainage of pus is done as treatment and antibiotics are given.

Key differences

  1. Piles are dilated inflamed veins in the lower part of the anal canal; fissures are  small cuts or tears around the anus and fistulas are areas of abscess or small opening around the anal skin.
  2. Piles and fissures occur due to low fiber diet or any condition that raise intraabdominal pressure while fistula occurs due to infections and poor hygiene.
  3. Adequate blood is released before or after passing stools in case of piles. No blood passes during stools in case of fissures. Pus is discharged in case of fistula.

Conclusion

Piles, fissures, and fistula are often considered the same thing. They are different entities, and it is mandatory for medical students and other persons to know the differences between them. In the above article, we learned the clear differences between piles, fissures, and fistula.

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