A lot of people deal with pain in the anal area but mistake piles (hemorrhoids) for a fistula. Although both these conditions create pain in the anal area and swelling, they are different in origin, symptoms and treatments. 

To find the difference between fistula and piles as well as to compare them and which ones require you to see Dr. Sandhya Gupta, an expert and well-known general surgeon from Gurgaon, who works on complex anorectal ankle treatments.

What exactly are Piles(Hemorrhoids)?

Piles are also known as hemorrhoids and are swollen and inflamed veins in the lower rectum or around the anus as they are one of the most common anorectal issues often linked to constipation or prolonged sitting. 

Types of Piles- 

  • Internal piles are located inside the rectum and often painless but may bleed.
  • External piles are found under the skin near the anus and can be painful.
  • Prolapsed piles when internal piles push outside the anus.

Symptoms:

  • Bright red bleeding during bowel movements  
  • Itching or irritation around the anus  
  • Pain or lump while sitting  
  • Mucus discharge after passing stool  

Causes:  

Chronic constipation, low-fibre diet, obesity, pregnancy and prolonged sitting are major triggers.

What Is Fistula?

Anal fistula is a small and infected tunnel that goes from the anal canal to the skin near the anus as the fistula develops when an anal abscess does not fully heal and it leaves a tunnel that continues to drain.

Types of Fistula-  

  • Intersphincteric runs between anal muscles
  • Transsphincteric crosses the anal sphincters 
  • Suprasphincteric / Extrasphincteric: even higher up

Common Symptoms:  

  • Pain and swelling near the anus that won't go away.  
  • Pus or awful-smelling liquid or discharge that comes from the tunnel.  
  • Abscesses that keep coming back.  
  • Fever or irritation of the anal skin.  

Causes:  

Chronic infection, abscess, inflammatory bowel disease or trauma.

Key Differences Between Piles and Fistula

Feature

Piles (Hemorrhoids)

Fistula (Anal / Perianal)

Nature

Swelling of anal veins

Infected tunnel between anal canal & skin

Pain

Usually mild, increases with thrombosis

Severe, throbbing, continuous pain

Bleeding

Bright red blood during stool

Rare, may discharge pus

Discharge

Sometimes mucus

Pus or foul-smelling discharge

Cause

Straining, constipation

Infection from abscess

Treatment Approach

Often managed conservatively

Mostly requires surgery

Healing Time

Quick with lifestyle changes or minor surgery

Longer recovery due to infection

 

How Are Piles Treated?

How your piles treatment is done, depends on how bad the condition is. Lifestyle changes work best for early or mild ones. Advanced piles or Hemorrhoid conditions might require surgical correction.  

The following are the most common approaches

Dietary changes- You must drink enough water and consume lots of fiber-rich foods.   

Topical medications- ointments and creams are used for easing pain and itch.  

Minimally invasive procedures-  

  • Rubber band ligation- solves by strangulating the piles.  
  • Laser piles surgery-modern, painless and quick recovery is guaranteed.  
  • Stapler hemorrhoidectomy- used on large prolapsed piles.

How Is a Fistula Treated?

Fistulas hardly ever heal by themselves and almost always need some type of medical care management of surgical management. The goal is to take away the infection and close the tract while protecting anal function.  

Treatment Options:  

  • Fistulotomy: The tract is opened and the tract is allowed to heal naturally.  
  • Seton Placement: A medical thread keeps the tract open for drainage.  
  • LIFT Procedure: Ligation of the fistula tract while preserving the muscles.  
  • Laser Fistula Surgery: Uses laser energy to close the tract with minimal pain and recurrence.

Post-Treatment Care and Recovery Tips

For Piles:  

  • Keep your anal area clean.  
  • Don’t strain. Eat meals with lots of fiber.  
  • Take Sitz baths often.  

For Fistula:  

  • Keep the area clean and dry.  
  • Take your antibiotics and care of the wounds as instructed.  

When Should You See a Doctor?

Consult a doctor if you notice:   

  • Chronic pain or bleeding when having a bowel movement  
  • Bleeding or swelling near the anus  
  • Abscesses or infections repeatedly   
  • Chronic symptoms can lead to complications.  

Why to choose Dr. Sandhya Gupta in Gurgaon?  

Dr. Sandhya Gupta is a best general surgeon in gurgaon. She does advanced laser surgery for piles and treatment for fistulas and anal fissures. Painless advanced treatment is performed in a safe environment.  

Dr. Sandhya Gupta specializes in patient-centered laser treatment for piles, fistula and fissure which is modern, painless and safe.  

Her clinic is advanced. She is committed to personalized treatment for each patient, which serves fast recovery and long-term relief in return.

Conclusion

Even though piles and fistula might look alike, they are totally different conditions and require different methods to treat them. Knowing the different conditions give the opportunity of timely response and management.

If you are having any anal pain, bleeding or pain you need to talk to an expert and one of the top general surgeons in Gurgaon, Dr. Sandhya Gupta and ask about laser treatment options. You will have a pain-free life again with the right treatment and diagnosis.