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Difference Between Piles and Fissure.

Difference Between Piles and Fissure: Piles vs Fissures.

Difference Between Piles and Fissure.

Irritable and itchy anal cavity, trouble passing stools, bloody stools, and discomfort when you sit for a long time? – chances are you may have experienced these conditions at some point in time in your life. You’re not alone! 50% of the Indian population suffers from hemorrhoids. It is reported that 20% of cases suffer from piles and fissures together. However, many of us often fail to understand the fundamental difference between piles and fissures since both have similar symptoms.

In this article, We explain the difference between piles and fissures.

What is the difference between piles and fissures?

Piles or hemorrhoids are inflamed veins in the rectal or anal region that may protrude outside, causing discomfort.

An anal fissure, on the other hand, is a small cut on the lining of the anal cavity.

Piles Vs Fissure

Here are some essential differences that can help you understand what are piles and fissures.



Swollen veins in the anal canal, rectum, or anus.

Tear or cut of the anal skin.


Painless during the initial phase and increases as the swelling becomes more prominent.

Very painful and uncomfortable with little or more bleeding.

Piles are a result of prolonged constipation, pregnancy or chronic cough, physical strain.

This occurs during pregnancy, as a result of obesity or an injury to the anal cavity, to people with Crohn’s disease, passing hard stools, and chronic diarrhea.

Piles and Fissure Overview

Piles and Fissure Overview.

Piles Vs fissures are often misinterpreted due to overlapping signs and symptoms. Here is a detailed overview of piles fissure to help you grasp a better understanding.
Piles can be broadly categorized into three types:
  • Internal Haemorrhoids
  • External Haemorrhoids
  • Thrombosed Haemorrhoids

The symptoms and treatment options purely depend on the kind of hemorrhoid you have and its severity. When deduced in the initial stages, you can even treat it with simple lifestyle changes and natural home remedies.

Internal Haemorrhoids.

Internal hemorrhoids occur as hard lumps in the back passage inside the rectal cavity. You might not feel them initially as that region has very few pain-sensing nerves. However, in case you have prolonged constipation or strained bowel movement, then this can cause occasional bleeding and pain.

4 degree of piles

Internal hemorrhoids can be further classified based on their severity:
  • First-degree hemorrhoids stay in the rectum. They may bleed but generally don’t cause much discomfort.
  • Second-degree hemorrhoids are a bit more swollen and prolapse when strained, usually during defecation. They return to the rectum on their own after some time.
  • Third-degree hemorrhoids don’t relapse on their own and need to be pushed in. These are a bit painful and take time to heal.
  • Fourth-degree hemorrhoids always remain outside the rectum and cannot be pushed back inside.

Some of the standard inner piles’ symptoms include:

  • Itching in the anal region.
  • Irritation and pain in the anus.
  • Leakage of stool.
  • Lump or swelling inside the anal cavity.
  • Occasional bloody stools due to rupture.

External Haemorrhoids.

External hemorrhoids are more prominent and painful as they occur in the outer region of your anal canal. They usually are covered with regular skin and have pain nerves surrounding them. This variant of piles is more painful and has a high risk of clots, skin tags, and other related skin infections.

Some of the standard inner piles’ symptoms include:

  • Itching around the anus or rectal area.
  • Pain around the anus.
  • Lumps near or around the anus.
  • Blood in the stool.

How are external hemorrhoids diagnosed?

Because many of the symptoms of external hemorrhoids can also be caused by other conditions, it is necessary to have an in-depth exam. Your doctor may use a series of tests to confirm the presence of external hemorrhoids near the anus. These tests may include:
  • Proctoscopy.
  • Digital rectum exam.
  • Colonoscopy.
  • Sigmoidoscopy.
  • Anoscopy.

Thrombosed Haemorrhoids.

Thrombosed hemorrhoids are characterized by a blood clot that prevents blood flow. Sometimes these hemorrhoids burst and start bleeding due to excessive blood. If you are wondering if these are bleeding hemorrhoids are dangerous, worry not! Although thrombosed hemorrhoids can cause a lot of pain and discomfort, they are usually benign.

Symptoms of thrombosed hemorrhoids include:

  • Pain when sitting, walking, or defecating.
  • Bleeding when defecating.
  • Itching around the anus.
  • Swelling or lumps around the anus.

Fissures Overview.

Unlike piles, anal fissures can be very painful right from the beginning. The light tear on the moist tissue of the anal region can cause painful itching and spams in the anal sphincter. Depending on the severity of the condition, fissures can be categorized as:

Acute Fissures.

Acute fissures are freshly developed and thus, can be treated easily. One can encourage the self-healing of these fissures with simple home remedies. If left untreated, however, they can manifest as chronic fissures in the future.

Chronic Fissures.

These are fissures that last for more than 8-12 weeks and need medical assistance to heal. Along with the anal tear, chronic fissures also involve a swelling commonly known as a skin tag, and extra tissue growth known as hypertrophied papilla.

Fissure Symptoms.

Usually, anal fissures entail a searing pain at the bottom. However, other fissure symptoms that you may experience are:
  • Occasional bleeding especially while defecating.
  • Tightening of the anus accompanied by a sharp spasm.
  • Painful boils may be filled with pus.
  • Mucus-like smelly discharge.
  • Best Treatment for Piles and Fissure.

A typical fissure or hemorrhoid is easy to manage and would take a minimum of 6-8 weeks to heal completely.

You can try the following methods for the best treatment for piles and fissures for faster healing:
  • Increasing your fiber and fluid intake can make the stools bulkier and soft. This would make it easier to pass through without causing any pain.
  • A cold compress and ice packs can help eliminate pain and is the best treatment for piles and fissure.
  • A sitz bath, which is a warm bath with salts, is a commonly prescribed and efficient home remedy for piles and fissures.
  • Wearing loose cotton clothing that doesn’t rupture the affected region further can alleviate the pain.
  • Drinking 500-600 ml of water on an empty stomach helps to activate the gastrocolic reflex (a contraction of your colon to release stools).
  • If the conditions persist for more than a week, it is best to get a medical consult.

Depending on the severity of the condition, your medical practitioner might prescribe stool softeners, over-the-counter creams, and topical ointments.

One can treat these health issues without operations, but in severe cases, your doctor may suggest surgery of piles and fissures. Depending on your condition, you can also opt for advanced methods including laser treatment for piles and fissures.

What to avoid in piles and fissures?

Certainly, you would know the difference between fissure vs piles. However, their symptoms can be managed by slightly altering your lifestyle.

Here are some recommendations you should follow if you are suffering from piles and fissures:

  • Avoid spicy food.
  • Avoid fried food.
  • Restrict the consumption of caffeinated beverages.
  • Avoid drinking alcohol.
  • Prevention of Piles and Fissures.

You can prevent the onset of piles fissures with good lifestyle choices. The preventive measures for these conditions entail promoting healthy bowel movements.

  • Eating high-fiber foods.
  • Drinking a lot of water.
  • Following a daily exercise regime.
  • Practice yoga for piles and fissure prevention.
  • Avoiding long hours on the toilet.

The concluding note.

For many people, discussing anorectal disorders can be embarrassing and acts as a barrier to getting the right care. But these issues are liable to worsen if not addressed immediately. To seek the right care, it is essential to stay informed about your condition. Thereby, one should know the primary difference between piles and fissures. To avoid further health complications, one must seek medical advice as early as possible.

FAQs about fissure and piles.

Ques:- What is the primary difference between piles and fissures?
Ans:- Piles are swollen blood vessels while fissures are cuts, tears, or cracks of the anal skin.

Ques:- How to get rid of piles permanently?
Ans:- To get rid of piles permanently, you should eat high-fiber foods, more fruits, vegetables, and whole grains.

Ques:- Can piles and fissures occur together?
Ans:- Piles and fissures can happen together or separately.