Difference Between Piles, Fissure & Fistula

Piles, fissures, and fistula are three related medical conditions that sound identical. As they even occur in the same part of the body, they are assumed to be similar to one another. However, that is not the case. Each of these conditions is as difficult to one another as is pain and discomfort caused by them.

In simple terms, piles are enlarged rectal veins, a fissure is a sharp cut in the anal lining, and an anal fistula is an irregular canal in the rectal wall. But there’s more to these rectal disorders than meets the eye.

Even the basic definitions of the terms fistula and fissure are more different than one may assume. A “fistula” in medical terms, is a channel resembling tubes between organs while a “fissure” refers to a skin tear. Consequently, a little tear or split in the wall of your anus is known as an anal fissure. This cut, however small, causes excruciating pain accompanied by blood during and after passing stools.

An anal fistula is an inflamed passageway between the skin and the anus. It is a type of a pus-filled anal blister that irritates the inner rectum and anal veins. Piles, on the other hand, appear inside the rectum or surrounding the anus and may develop into uncomfortable clots close to the anus.

But how do we tell the difference between each of these terms and how do we differentiate their symptoms from one another? Keep reading below to know all this and also find out the best way to treat fistula, fissures, and piles.

What are anal disorders?

The anus is the part of the intestinal system that travels through the anal sphincters and neuromuscular canal of the pelvis. It is the body’s last opening via which food wastes are excreted from the system.

The anus measures 4 to 5 cm in length in adults, and the anal canal’s lower half is lined with delicate nerve fibers. It also contains numerous arteries and several microscopic anal glands. Any disturbance to this canal in the form of a tear, external pressure or blockage can cause an anal disorder. Here are some major anal disorders that might need immediate medical assistance.

Anal fissure

A longitudinal split or tear in the anoderm that lines the lower anal canal is an anal fissure, also known as an anorectal fissure. Most anal fissures are caused by big, hard stools that can stretch the anal orifice past its limit and rupture the delicate anoderm.

Anal fissures are less frequently induced by chronic diarrhea, inflammatory bowel illness, or STIs that affect the anorectal region. Acute (short-term) anal fissures are typically superficial and shallow. Persistent (long-term) anal fissures may go deeper into the anoderm to reveal the underlying muscle layer.

Anal abscess

A painful, pus-filled swelling close to the anus is known as an anal abscess. Most anal abscesses develop independently for unknown reasons unrelated to other medical conditions. They start in the microscopic anal gland that enlarges due to an infection site beneath the skin.

Anal abscess affects more than 50% of young adults aged 20–40 worldwide and is more frequent in men than in women. Most anal abscesses are found close to the anus’ opening and might sometimes develop higher up or deeper in the anal canal, closer to the pelvis or lower intestine.

Anal fistula

A drained anal abscess leaves behind an abnormally small, tunnel-like tube known as an anal fistula. It connects the anal canal to the surface of the skin. An anal fistula will grow at least 50% after an anal abscess has emptied (either naturally or mechanical stress).

Sometimes pus or red fluid is discharged continuously from the fistula’s opening at the skin’s surface. In some instances, the fistula’s entrance temporarily closes, reactivating the original anal abscess as a severe pus pocket.

Hemorrhoids

While hemorrhoids do not hurt, minor bleeding around the anal orifice’s border can cause the blood vessels to thicken (“thrombosis”). A bout of diarrhea or constipation is the most prominent symptom, and external hemorrhoids become large, hard, and painful and occasionally discharge blood when thrombosis occurs.

How to Differentiate between Piles, Fissures, and Fistulas?

Piles

Piles are a group of enlarged veins and tissues in the lower rectum and anus. They can occur either on the inside or outside of the body. External hemorrhoids form on the skin surrounding the anus, and internal hemorrhoids form inside the anal canal. The size of these hemorrhoids can vary depending on the clots. Constipation, persistent diarrhea, carrying heavy objects, pregnancy, and straining when passing stools are the common causes of piles.

While Hemorrhoids typically go away on their own and don’t need medical attention, treatment is required in case the condition worsens. The type and location of the piles affect the extent of symptoms and discomfort experienced by patients.

External hemorrhoids can cause various symptoms, including swelling, bleeding, pain, and irritation in the anal area. Internal hemorrhoids, though not visible, can be equally or more painful than external piles and are known to bleed while passing stools. Internal hemorrhoids that protrude from the anal canal cause more discomfort and make normal tasks like sitting or sleeping.

Anal Fissures

An anal fissure is a rupture in the mucosa, the inner lining of the rectal wall. When the skin tears, it bleeds profusely during and after bowel movements. An anal fissure can afflict people of any age, though it is most frequently- observed in infants and young children. The fissure typically heals by itself in a month to six weeks. However, if it continues after then, it may be regarded as chronic. The fissure can occasionally be deep enough to reveal muscle tissue.

Constipation, struggling during bowel motions, passing large, hard stools, diarrhea, delivery, and anal intercourse are the most typical causes of an anal fissure. The following signs and symptoms of an anal fissure involve mild to severe distress during bowel movements.

A noticeable tear or crack on the skin around the anus, a small bulge close to the tear, streaks of blood after passing stools on the toilet seat or the tissue paper, and pain that persists for a long time after bowel movements.

Anal Fistula

A tiny underpass is an anal fistula that forms close to the anus between the anal canal and the skin. They frequently arise from an infection close to the anus that results in an abscess. A tiny tube may remain left once the pus drains. The center of the anus becomes infected in the fistula and creates an abscess that begins to seep pus.

Read more on: Preventive Steps to Avoid Fistula | Preventive Steps to Avoid Fissures | Preventive Steps to Avoid Piles

The sooner you can diagnose the condition and differentiate it from the many rectal conditions, can you begin to seek treatment. Ayu Health Hospitals are the best place to get accurate diagnoses and treatments for all your rectal problems.