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Itchy, irritated anal canal? Facing trouble passing stools? Experiencing bloody stools? Suffering from discomfort while sitting for too long? Chances are you must have experienced this symptom at least once in your life. But it could be a serious problem if you have been experiencing it often. But you are the only one! Reports suggest that more than 50 per cent of the Indian population suffer from haemorrhoids. It was also found that 20 per cent of the population have anal tears or fissures. Since piles and fissures show similar symptoms, many people become unable to differentiate between the two.
In this article, DR. LOVKESH ANAND, HOD - Hepatology, Consultant Gastroenterology, HCMCT Manipal Hospital, Dwarka answers all questions about the difference between piles and fissures. Also, the treatment options available can help you fix the problem.
The majority of people are unable to identify the cause of pain or discomfort in the lower area. They are unable to distinguish between piles and fissures. Both piles and fissures have comparable symptoms. Both these conditions are relatively common and in most cases, any bleeding is not a cause for alarm. However, any bleeding from the anus should always be investigated immediately as it may be a symptom of a more serious condition. Usually, the doctor can diagnose the condition by visual inspection of the anus or by gentle exam with the tip of the finger. A colonoscopy or sigmoidoscopy is often advised to evaluate and differentiate the two.
When a person experiences pain or discomfort near the anal area or sees blood in stool or toilet paper, he suspects piles. Piles are caused by enlarged blood vessels or tissues in the anal area and anal canal as a result of chronic constipation and excessive pressure caused by long sitting hours. A fissure is caused by a tear in the skin around the anus or anal entrance.
Symptoms of piles include itching or irritation in the anal region, slimy mucus in your underwear or on toilet paper after wiping your bottom, pain or discomfort, swelling around your anus or bleeding. Fissures, on the other hand, typically cause a sharp pain that starts with the passage of stool. This pain may last several minutes to a few hours. As a result, many patients may try not to have bowel movements to prevent the pain. In the early phases of the fissure, bleeding is rarely seen. A small lump or skin tag on the skin is often seen near the anal fissure, especially in chronic cases.
Straining during bowel movements, sitting for long periods of time on the toilet, chronic diarrhoea or constipation, chronic coughing, being obese, regular heavy lifting and pregnancy put a lot of strain on the veins in the anal area, causing piles. Common causes of an anal fissure include passing large or hard stools, constipation and straining during bowel movements, chronic diarrhoea, anal intercourse and childbirth. Less common causes of anal fissures include Crohn's disease or another inflammatory bowel disease, anal cancer, HIV, tuberculosis and Syphilis.
Generally, piles are not that serious. They normally get okay in a few days. In case they don't,
Piles are easily treated by over the counter medication, home remedies and in a few cases minimally invasive procedures. Fissures, on the other hand, cause a lot of pain. Fissures may fail to heal, may recur and may extend to the surrounding muscles making it difficult to heal. Thus, in many cases, medication and surgical procedures like lateral sphincterotomy may be required.
Early-stage piles can be treated with medicine, a healthy, high-fibre diet, and plenty of water throughout the day. Ice packs and cold water provide immediately, but only brief, pain relief. For persistent bleeding or painful haemorrhoids, your doctor might recommend one of the other minimally invasive procedures like band ligation, injection sclerotherapy or coagulation techniques. available. These procedures can normally be performed without anaesthetic in your doctor's office or another outpatient environment. Only a small percentage of people with haemorrhoids require surgery like Hemorrhoid removal (hemorrhoidectomy), or Hemorrhoid stapling.
Fissure treatments try to promote fast healing by relaxing the anal sphincter through the passage of soft stool. Simple therapies, such as increased fibre intake or sitz baths, can help most anal fissures heal. Anal fissures may necessitate medicine or, in rare cases, surgery. An anal fissure that fails to heal within eight weeks is considered chronic and may need further treatment. A patient with an acute fissure is advised to undergo surgery to cure it. Botulinum toxin (Botox ) injection into the anal sphincter or surgical division of an inner part of the anal sphincter is two surgical approaches (lateral internal sphincterotomy). It can take 6 to 10 weeks for both medicinal and surgical therapies to fully heal. It's crucial to keep healthy bowel habits and eat a high-fibre diet even when the discomfort and bleeding subside.
The key to prevention is proper diet and habits to produce softer stools, thus reducing the need to strain. Have a high fibre diet (fruits, vegetables, legumes, and whole grains) and drink plenty of fluids (8 to 10 glasses of water daily) regularly. Don't hurry or strain to push bowel movements but avoid prolonged toilet sitting. Avoid vigorous wiping after bowel movements (to decrease irritation) and exercise regularly.
Discussing anorectal diseases can be humiliating for many people, and it can prevent them from receiving the care they need. However, if these problems are not addressed right away, they are likely to get worse. It's critical to keep informed about your health in order to get the best treatment. As a result, one should be aware of the basic distinction between piles and fissures. To avoid further health problems, it is critical to seek medical counsel as soon as possible.