The Silent Epidemic: Understanding India’s Growing Digestive Health Crisis
India witnesses a staggering surge of over 20 million documented pile cases annually, marking this condition as one of the nation’s most prevalent yet overlooked health challenges. The epidemic had a major impact on our lifestyles, leading to sedentary habits and an increased reliance on harmful processed foods. This resulted in a “perfect storm” of digestion and weight disorders, making piles a common worry for people of all ages, not just the elderly.
Furthermore, a prevalent misperception is that piles, anal fissures, and fistulas are all the same. Despite common symptoms that can lead to confusion, these are distinct illnesses that require separate diagnoses and treatment.
Anal Discomfort? Let’s Talk About It!
Pain, blood, or discomfort during bowel motions can be distressing and confounding, but these problems are considerably more frequent than you might believe. You may be coping with hemorrhoids (piles), anal fissures, or fistulas. While their symptoms may overlap, their causes and treatments are entirely different.
What are anal disorders?
Anorectal disorders also known as anal disorders where the anus and rectum are affected by conditions such as hemorrhoids, anal fissures, and anal fistulas. For many people, these anorectal problems frequently result in severe physical pain, discomfort, anxiety, and shame.
As food digests, it moves through the digestive tract. Any remaining waste stuff is ejected from the body in the form of feces, commonly known as stool. Anal problems impact the anus, which is where stools are passed. The anus is the portion of the digestive tract that links to the outside of the body. Rectal illnesses affect the rectum, which is the area above the anus where stool is stored before being transported out of the body.
Let’s understand how piles, fissures, and fistulas are different from each other.
1. What Are Hemorrhoids (Piles)?
Hemorrhoids, commonly called piles, are swollen blood vessels in the rectum or anus. They can be internal (inside the rectum), which are usually painless, or external (around the anal opening), which can be painful and itchy.
Symptoms of piles
As it can be seen that piles are common in both men and women. So, are the symptoms of piles differ in both. Which can be seen as follows-
- Symptoms of piles in women
Piles are common in women during pregnancy, due to increased rectal veins, hormonal imbalances and constipation. Symptoms like swelling, itching and bleeding which may worsen further. - Causes of piles in women:
In women, piles are frequently linked to pregnancy due to uterine pressure and hormonal changes. Constipation, low-fiber diet, and obesity are also major factors. Understanding these causes helps in prevention through better diet, activity, and weight management.
Causes of piles
- Symptoms of piles in men
Experiencing bright red blood when you use the toilet, a painful lump or swelling around the anus, or discomfort during bowel movements? You might also feel itching, irritation, a sense of incomplete emptying, or notice mucus discharge. These are common signs of certain anal conditions.
- Causes of piles in men:
lifestyle factors like prolonged sitting, heavy lifting, and a low-fiber diet, which increase pressure on rectal veins. Poor lifestyle choices and obesity can further elevate this risk.
2. What Is an Anal Fissure?
An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools or severe constipation, commonly found in people above the age of 50. Fissures can appear in a variety of forms, including acute and chronic ones. It’s like a paper cut but located in the anal canal, and it can cause intense pain.
Symptoms of Anal Fissure:
- Sharp, burning pain during or after bowel movements
- Bright red blood on toilet paper or in stool
- A visible tear in the anal lining
- A small skin tag near the fissure is chronic
Causes:
- Passing large or hard stools
- Chronic diarrhea or constipation
- Childbirth
- Anal trauma or infection
3. What Is an Anal Fistula?
An anal fistula is an abnormal tunnel between the anal canal and the skin near the anus. It usually forms due to an abscess or infection that didn’t heal properly. Just inside the anus are a number of small glands that make mucus.
Symptoms of Anal Fistula:
- Persistent pain and swelling around the anus.
- Pus, blood, or foul-smelling discharge from a skin opening near the anus.
- Skin irritation around the anal area due to discharge.
- Recurrent anal abscesses.
- Pain that worsens with sitting, coughing, or bowel movements.
- Fever and general unwellness in some cases.
Causes:
- Complications from an anal abscess
- Inflammatory bowel disease (Crohn’s disease)
- Previous anal surgeries or infections
- Tuberculosis or radiation
How to Tell the Difference between piles, fissure and fistula?
| Feature | Haemorrhoids | Anal Fissure | Anal Fistula |
| Pain Level | Mild to Moderate | Sharp/Stinging Pain | Persistent & Throbbing |
| Bleeding | Bright red blood | Bright red blood | May have blood/pus |
| Discharge | Rare (mucus) | No discharge | Pus or smelly fluid |
| Lump/Swelling | Common | Sometimes (chronic) | Common |
| Infection Risk | Low | Low | High |
| Treatment Type | Conservative Surgery | Topical/Surgery | Surgical (required) |
What are the complications related to piles, fissure and fistula?
Piles form when delicate rectal veins become inflamed due to high pressure, which is commonly caused by straining during bowel movements, constipation, diarrhea, heavy lifting, or pregnancy. Symptoms include bright red blood, chronic anal discomfort, and acute pain during feces.
Anal fissures are small tears in the anal canal lining. They are primarily caused by passing hard feces, chronic constipation, delivery, anal trauma, or persistent diarrhea. In less common cases, underlying illnesses such as Crohn’s disease, HIV, anal malignancy, TB, or syphilis can cause them.
Anal fistulas form when blocked anal glands lead to infected abscesses. These tunnels usually require surgery by colorectal surgeons. The goal is to remove the fistula while protecting sphincter muscles to prevent fecal incontinence.
What are the preventive measures that can be taken to avoid these?
Although piles and anal fissures are typically modest, they can worsen. Piles become severe when they form unpleasant, bloated knots or when the blood supply is severed (strangulated hemorrhoid), resulting in great discomfort or clotting (thrombosed). Similarly, unhealed anal fissures necessitate medical intervention to avoid problems.
However, fistulas usually require professional medical treatment; home treatments will not work. To restore normalcy, the infection is often drained using medicines and surgery. Untreated fistulas can develop into more complex, difficult-to-cure fistulas with a higher recurrence rate. Early intervention is critical.
When to See a Doctor?
If you’re experiencing persistent symptoms such as bleeding, severe pain, or discharge, don’t delay seeing a doctor. Early diagnosis can prevent complications and lead to faster healing.
A note from True Hospitals
At True Hospitals, we understand the discomfort and confusion surrounding anorectal conditions like piles, anal fissures, and anal fistulas. While they affect the same sensitive area and share some symptoms, they are distinct conditions requiring different approaches to treatment.
Piles are swollen veins, often from straining. Anal fissures are small tears, usually from hard stools. Anal fistulas are infected tunnels, typically needing surgery. Don’t let embarrassment delay your relief. Our expert team provides precise diagnosis and compassionate, personalized care to ensure you receive the right treatment and get back to comfort.
At True Hospitals, we don’t just treat symptoms—we restore comfort, dignity, and quality of life.
Frequently Asked Questions (FAQs)
Q1: Are hemorrhoids and fissures the same?
A: No. Hemorrhoids are swollen veins, while fissures are small tears in the anal lining.
Q2: Does a fistula heal on its own?
A: Fistulas cannot heal on their own without proper medications/surgery. If left untreated for an extended period of time, they can result in serious complications.
Q3: Is bleeding from the anus always serious?
A: Not always, but it should never be ignored. It could be a sign of hemorrhoids, a fissure, or something more serious.
Q4: Are these conditions contagious?
A: No, they are not contagious. However, untreated fistulas caused by infections can spread internally.
Q5: How soon can I resume work after laser surgery?
A: Most patients at True Hospitals return to work within 24–48 hours after laser treatment.
Q6: What foods should I avoid if I have any of these conditions?
A: Avoid spicy food, caffeine, alcohol, and low-fiber diets. Drink plenty of water and eat fiber-rich foods.
Q7: Is surgery painful?
A: Not with us. At True Hospitals, we perform painless laser procedures under local or short-term anesthesia, ensuring maximum comfort.
Final Thoughts
Understanding the distinctions between hemorrhoids, fissures, and fistulas is critical to relief. True Hospitals provides skilled consultation, accurate diagnosis, and advanced treatment.
Your comfort is our commitment. Book a consultation with our proctology doctor today to live pain-free. Prioritize your health – you hold the power!