Know the Difference Between Piles and Fissures

An itchy, irritable anal cavity, constipation problems, bloody stools, and discomfort from prolonged sitting? It’s likely that you have come across these circumstances at some point in your life. It’s not just you! In India, hemorrhoids affect 50% of the population. According to reports, 20% of cases have both piles and fissures. However, since both piles and fissures have comparable symptoms, many of us frequently fail to understand the fundamental distinction between the two.

Aarogya Dham Hospital, a Piles doctor in Chandigarh, outlines the distinction between piles and fissures in this article.

What Is the Difference Between Piles and Fissures?

Inflamed veins in the rectal or anal region that may protrude outside are known as piles or hemorrhoids and can be painful. Contrarily, an anal fissure is a tiny cut on the lining of the anal cavity.

  1. Piles (Hemorrhoids):Piles are swollen blood vessels in the rectum or anus. They can be internal (inside the rectum) or external (under the skin around the anus). Common symptoms include rectal bleeding, itching, pain, and discomfort during bowel movements. Piles are often caused by increased pressure in the rectal or anal area, such as straining during bowel movements, chronic constipation or diarrhea, obesity, or pregnancy. Treatment options include lifestyle changes, dietary adjustments, topical creams, procedures like rubber band ligation or sclerotherapy, and in severe cases, surgery.
  2. Anal Fissures: Anal fissures are small tears or cracks in the lining of the anus, typically causing pain and bleeding during bowel movements.
  3. They are usually caused by trauma to the anal canal, such as passing hard or large stools, chronic diarrhea, or childbirth.
  4. Common symptoms include pain during and after bowel movements, bright red blood on the stool or toilet paper, itching, and spasms in the anal sphincter.
  5. Anal fissures often heal on their own with proper self-care measures, including keeping the anal area clean, using stool softeners to prevent constipation, and taking sitz baths. In some cases, medications or surgical procedures may be necessary if the fissure doesn’t heal.

Overview of Piles and Fissures

Due to overlapping symptoms and signs, fissures vs. piles are frequently misdiagnosed. To help you better understand piles fissures, here is a thorough overview.

Overview of Piles

In general, there are three types of piles:

  • Internally bleeders
  • Outside hemorrhoids
  • Thrombosed hemorrhoids    

 Difference Between Piles and Fissures

The type of hemorrhoid you have and its severity solely determine the symptoms and available treatments. 

When detected early on, you can even treat it with straightforward lifestyle adjustments and natural remedies from your own home.

Internal hemorrhages

Internal hemorrhoids appear as solid lumps in the rectal cavity’s back passage. Since there are not many pain-sensing nerves in that area, you might not initially feel them. 

However, if your bowel movements are difficult or prolongedly constipated, this may occasionally result in bleeding and pain.

The severity of internal hemorrhoids can be used to further categorize them:

Hemorrhoids in the first degree remain in the rectum. They may bleed, but they typically don’t hurt too much.

Second-degree hemorrhoids tend to be slightly more swollen and prolapse under strain, typically during feces. After a while, they come back to the rectum on their own.

Third-degree hemorrhoids require pushing in because they don’t relapse on their own. These hurt a little and take a while to heal.

Fourth-degree hemorrhoids can never be forced back inside the rectum and always stay outside.

The following are a few signs and symptoms of inner piles:

  • Itching around the anal area
  • Annoyance and discomfort in the anus
  • Stool leakage
  • Internal lump or swell in the anal cavity
  • Sometimes bloody stools because of rupture

External hemorrhoids

Because they develop in the outer region of your anal canal, external hemorrhoids are more noticeable and painful.

They typically have normal skin coverings and are surrounded by pain nerves.

In addition to being more painful, this type of pile carries a high risk of blood clots, skin tags, and other skin infections.

Blood-filled hemorrhoids

A blood clot that stops blood flow is a characteristic of hemorrhoids that have thrombosed.

Sometimes the excess blood causes these hemorrhoids to rupture and begin bleeding.

Do not be concerned if you are unsure whether these bleeding hemorrhoids are dangerous.

Despite the fact that thrombosed hemorrhoids can be extremely painful and uncomfortable, they are typically benign.

Overview of Fissures

Anal fissures, in contrast to piles, can be extremely painful right away. Anal sphincter spasms and painful itching can result from a small tear in the moist tissue of the anal region.

Fissures come in different degrees of severity and can be classified as:

Significant fissures

Since acute fissures have just formed, they are simple to treat. With easy home remedies, one can promote the self-healing of these fissures.

However, if unattended to, they might later develop into chronic fissures.

Persistent fissures

These are fissures that require medical attention to heal and last longer than 8 to 12 weeks.

Chronic fissures include an anal tear, a skin tag-like swelling, and an additional tissue growth known as a hypertrophied papilla.

Symptoms of Fissure

Anal fissures typically involve a burning pain at the bottom. However, there are other fissure signs and symptoms you might encounter:

  • Occasional bleeding mostly while defecating
  • A sharp spasm and tightening of the anus were both present.
  • Painful boils that may be pus-filled
  • The stench of mucus-like discharge


Discussing anorectal disorders can be uncomfortable for many people, which prevents them from receiving the proper care. But if these problems aren’t resolved right away, they might get worse.

It’s crucial to remain knowledgeable about your condition in order to receive the proper care. 

Therefore, it is important to understand the main distinction between piles and fissures.

To avoid further health complications, one must seek medical advice from a Piles doctor in Chandigarh.

Visit Aarogya Dham Hospital or make an appointment with a Piles doctor in Chandigarh to receive the best kshar sutra treatment available for piles and fissures.