Piles/ Fissures

Piles, also known as hemorrhoids, and anal fissures are two common conditions affecting the anal region, each with distinct characteristics and causes. While they both can cause discomfort and pain, they differ in terms of their symptoms, presentation, and treatment approaches.

Piles (Hemorrhoids):

• Piles are swollen and inflamed veins in the rectum and anus that can cause itching, bleeding, and discomfort, particularly during bowel movements. They can occur internally, inside the rectum, or externally, under the skin around the anus.
• Common causes of piles include straining during bowel movements, chronic constipation or diarrhea, obesity, pregnancy, and prolonged sitting or standing.
• Symptoms of piles may include pain, itching, bleeding during bowel movements, swelling or lumps around the anus, and mucus discharge.
• Piles are classified into four grades based on their severity, ranging from grade I (small swellings inside the rectum) to grade IV (large, permanently prolapsed piles).
• Treatment for piles depends on the severity of symptoms and may include lifestyle modifications such as dietary changes, increased fiber intake, and topical treatments to reduce inflammation and relieve symptoms. In more severe cases, procedures such as rubber band ligation, sclerotherapy, infrared coagulation, or surgical removal may be necessary to alleviate symptoms and prevent complications.

Anal Fissures:

• Anal fissures are small tears or cracks in the lining of the anal canal, typically caused by trauma during bowel movements, passing hard stools, or straining. They can result in pain, bleeding, and discomfort, particularly during or after bowel movements.
• Common symptoms of anal fissures include sharp or burning pain during bowel movements, bright red blood on the toilet paper or in the stool, itching or irritation around the anus, and spasms of the anal sphincter muscles.
• Anal fissures are usually diagnosed based on symptoms and physical examination. In some cases, additional tests such as an anoscopy or sigmoidoscopy may be performed to evaluate the extent of the fissure or rule out other conditions.
• Treatment for anal fissures often involves conservative measures such as dietary changes to soften stools, topical treatments to relieve pain and promote healing, and sitz baths to soothe the affected area. In cases where conservative measures fail to provide relief, medical procedures such as botulinum toxin injection, topical nitroglycerin, or surgical repair may be considered.