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What are Piles and Anal-Fissure?

What is Piles and Fissure

Are you facing or experiencing hemorrhoids or Piles? Are you feeling embarrassed to talk about it? Do you want to know all about Piles and Anal-Fissure?

There is no need to feel embarrassed or ashamed of any of these conditions that you are facing. Indeed, these are quite uncomfortable and painful conditions to live with. A person who is suffering from such a condition would definitely like to know more about it but often hesitates to discuss it. Let's talk about this delicate topic of Piles and Anal-Fissure, for those who find it difficult to speak up and discuss.

Piles are referred to as Hemorrhoids in medical terminology. It’s commonly known as Bawasir or Bwaseer in Hindi, Arsha in Sanskrit, Mulvyadh in Marathi, Haras Masa in Gujarati, Bavasir in Punjabi, Arsha Roga in Bengali, Odia, and Assamese, Moolakkuru in Malayalam, Moolam in Tamil, Molalu in Telgu, and Mulavyadhi in Kannada. These vernacular terms for Piles in the various Indian languages, clearly show how prevalent this anorectal disease is across the length and breadth of our country.

Piles are one of the most common anorectal conditions, encountered by doctors. The prevalence of Piles is around 5% in any given population. Studies show that there is a 50% chance of developing the symptoms of Piles once in a lifetime. Piles are more common among adults aged 45 years to 65 years. However, there are several cases reported, where a person of younger age has been diagnosed with Piles or Fissure.

Fissure is also quite prevalent with over 1% of the given population suffering from it. There are several reasons which can lead a person into developing one of these conditions. Many times, chronic constipation often leads to Piles, and also fissures.

1. Understanding Piles and Fissures

Piles or hemorrhoids are swollen veins in the lower part of the anal canal (rectum and anus), which are usually painless during the early stages.

A Fissure is a small tear or a cut in the skin of the anal region. It causes severe pain and, at times, even bleeding when a person passes stools.


People experiencing Piles and Anal-Fissure are often unaware of the reasons. There are many reasons which can cause these conditions like a strenuous bowel movement, spasms, trauma, and so on. The following are some of the specific reasons for the cause of Piles and Anal- Fissure

  • Straining during bowel movements
  • Having chronic constipation
  • Inadequate intake of water on a regular basis
  • Eating a low-fibre diet
  • Pregnancy can put pressure on the perineum
  • Sitting for long periods of time in the toilet
  • Regular heavy weight lifting
  • Obesity

3. Symptoms of Piles and FISSURE

An individual who is experiencing the conditions like Fissures and Piles may show the following symptoms.

  • The area around the anus could be red, sore, and itchy
  • The passing of bright red blood during a bowel movement
  • A searing, sharp, and burning pain during the passing of stool happens in or around the anus
  • Spasms develop in the muscles around the anus during the passing of faces
  • A hard and painful lump develops around the anus, which contains coagulated blood. Such Piles are known as thrombosed external hemorrhoids

4. Stages of Piles

Piles can be divided into two categories, namely internal Piles, and external Piles. Internal Piles develop inside the anal canal, but they may come out or prolapse and hang outside the anus in the advanced stages.

An individual with Piles or Fissure has to understand the four Piles stages or grades.

Grade One - They are small and non-perceptible inflammations inside the lining of the anus with bleeding after passing stool and some itching in the anal region.

Grade Two - Here, the Piles are slightly larger than the stage one Piles but are still inside the anus. They are often pushed out while passing stools but return to their normal position after the passing of stool.

Grade Three - Prolapsed hemorrhoids or stage three Piles appear outside the anus and can be felt hanging from the rectum, but can be pushed with the help of fingers easily.

Grade Four - Prolapsed or the hanging Piles do not go back and require treatment as they are large and continuously remain outside the anus. They cannot be pushed back even with the help of the fingers.

One must remember that external Piles form small lumps on the outside edges of the anus and become very painful. The itchy blood clots develop and can block the flow of blood. Thrombosed external Piles that have clots require immediate medical treatment.

5. Acute and Chronic Anal-Fissure

Anal Fissure is a cut or a tear near the anal opening, and it is very painful as it takes a lot of time to heal, due to regular bowel movements. It does not differentiate between men and women and can happen to anybody at any age.

Sometimes it becomes difficult to identify if a person has an anal fissure, as in some cases there could be a small lump of the skin or a skin tag, near the anal opening. Generally, this happens in the case of chronic Fissures.

It is easy to treat acute Fissure, where a patient is suffering for less than 6 weeks, with medicines. For the treatment of chronic Fissure, where the patient is suffering for more than 6 weeks, medication could be advised first, but surgery could also be advised depending on the severity of the condition.

6. Diagnosis for Piles and Anal-Fissure

For diagnosing Piles or Fissures, the doctor usually carries out a physical examination of the anal region of the person. They also ask specific bowel-related questions. A doctor may also perform Digital Rectal Examination (DRE) or use a Proctoscope for examining the anal canal. The doctors may take a small tissue sample from inside the rectum or advise a Colonoscopy if there is a doubt of Colorectal Cancer or any other underlying condition.

A self-diagnosing patient questionnaire – Pilennaire for Piles and Fissure is developed by Healing Hands & Herbs in collaboration with the doctors at Healing Hands Clinic. It can be used by patients, for an early diagnosis and timely treatment of these conditions.


Piles or Fissures can be painful, discomforting, and even embarrassing for a person experiencing them. However, Piles usually do not pose a threat to life and can be medically treated, or even self-managed with over-the-counter medications, in the early stages.

For the late third and fourth stages of Piles and chronic Fissures, often, surgery is the final treatment advised by expert Proctologists – surgeons and doctors who treat anorectal conditions like Piles and Anal-Fissure. Modern surgical procedures like Laser surgery for Piles and Fissures are usually outpatient procedures with a minimum period of recovery.

Prevention is always better than cure. A person should do everything to avoid developing Piles or Fissures, which entails making necessary changes to the routine diet and lifestyle. May it be a natural remedy, home remedy, Ayurveda, or over-the-counter medicines, they should be used for the treatment as soon as possible. Lethargy on the part of the patient may lead to complications, causing discomfort, and prolong the time to recovery.

The newly introduced revolutionary spray for Piles and Fissures, PiloSpray is now readily available, making the treatment of Piles and fissures, easily manageable, and hands-free.

The innovative complete Piles treatment kit, PiloKit with a one-of-its-kind combination of a spray PiloSpray, a Piles tablet PiloTab, and a laxative tablet ConstiTab offer a complete treatment protocol for medical management of Piles and Fissure.

These innovative solutions have made this difficult journey of recovery from Piles to Smiles quite fast, easy, and comforting for the patients.

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