Difference between Piles vs Fissure

By Manav Sodhi +2 more

check_circle Medically reviewed by Dr. Nikita Toshi

Last updated: Nov 24, 2023

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What is Piles?

Piles or haemorrhoids are swollen blood vessels around the anal opening. It can cause pain, blood loss with stools and discomfort while sitting, walking and other movements. Piles can either be internal and form within the rectum, or they can be external and protrude beyond the anus.

As you age, piles are more frequent. I strongly recommend the following actions that may aid in avoiding constipation and hard stools that results in piles: Avoid using the loo for too long or too firmly. When the desire strikes, use the loo right away; don’t wait. Drink a lot of water all day long. Increase your intake of whole grains, fresh fruits and vegetables, and other high-fibre meals. Continue to be active. Bowels continue to move when you’re moving. Only take laxatives or enemas as directed by your healthcare professional. Your body may struggle to control your bowel movements if you use laxatives or enemas too frequently.

Dr. Smita barode, BAMS

What is Fissure?

Fissure is a small tear in the soft tissue lining of the anus. It occurs mainly due to the passing of hard stools and can cause significant pain and bleeding during bowel movements. Anal fissures are common in young infants but may affect people of any age.

While you have symptoms of fissures, I recommend you increase your water intake, increase the amount of fresh produce you eat and stay away from spicy foods and beverages.

Dr. Rajeev Singh, BAMS

Table of Differences between Piles and Fissures

Different Factors	Piles	Fissure
Causes	Due to excess pressure or strain, the veins around your anus may stretch and swell. Piles may develop due to: > Obesity > Regular heavy lifting > Pregnancy > Constipation > Diarrhoea	The rare causes of anal fissures include: > Passing Hard stools > Anal intercourse > Crohn’s disease or any inflammatory bowel disease. > Tuberculosis. > Syphilis.
Symptoms	> Itching or irritation in the anal area > Bleeding during bowel movements > Pain/discomfort while passing stools > Discomfort while prolonged sitting or standing up	> Pain during bowel movements and after, lasting up to several hours > A visible crack around the anus > Blood on stools or toilet paper after wiping the anus
Diagnosis	> Digital examination or clinical examination by inserting a lubricated finger into your rectum and looking for any unusual swellings.	> Physical examination to check for the cut or tear, which is often visible around the anal opening.
Treatment options that can be advised by doctors	> Medicines for local application > Soak the anal area in warm water or a sitz bath. > Rubber band ligation is done by using rubber bands around the base of an internal haemorrhoid to cut off its blood circulation. > Injection (sclerotherapy) is done to shrink the tissues in the haemorrhoid. > Haemorrhoid removal (hemorrhoidectomy) to remove excessive tissue that causes bleeding > Haemorrhoid stapling to block blood flow to haemorrhoidal tissue > Laser surgery for piles	> Externally applied medications can be prescribed. > Deep and chronic fissures usually require surgical treatment. – Surgery for a fissure is known as lateral internal sphincterotomy (LIS), in which a small part of the anal sphincter muscle is cut to reduce spasm and pain. > Laser suregry for anal fissures
Prevalence	Piles is very common in adults. Women are more prone to developing haemorrhoids than men.	Anal fissures are more common in young infants
Complications	> Anaemia – Chronic blood loss due to piles may lead to anaemia. > Strangulated haemorrhoid – If the blood supply to an internal haemorrhoid is cut off, the tissue may get severely infected and can cause extreme pain. > Blood clot – Occasionally, a clot can also form in a haemorrhoid due to a lack of blood flow (thrombosed haemorrhoid). It can be extremely painful.	> Failure to heal within eight weeks means it is considered chronic and needs further treatment. > Recurrence you are prone to having fissures if you had it previously. > A tear that extends to the surrounding muscles. It delays the healing of anal fissures, which causes discomfort and may require medicines or surgery.

From my knowledge, fissures are the most typical cause of anal discomfort despite piles being more prevalent. Even while piles may not always hurt, 90% of fissures do. However, piles may provide persistent pain and agony, yet fissures often cause bouts of pain at times.

Dr. Siddharth Gupta, MD

Conclusion:

It is possible to confuse the two conditions, namely piles and fissures, as their symptoms are very similar. If you do not seek timely treatment, your condition may worsen over time. It is important to understand the difference between piles and fissures, so get yourself diagnosed by a certified doctor or proctologist if you experience pain or discomfort or notice blood in your stools and other symptoms. Prompt treatment will ensure that you are pain-free and there are no serious complications. Never self-medicate if you suffer from either of these two conditions.

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