Piles , Fissure, Fistula - Dr. Bhavesh Doshi, Pediatric Surgeon

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Piles surgeon in borivali


Piles, also known as hemorrhoids are the swollen veins located around the anus in the lower rectum.

An anal fissure is a tear or cuts in the skin around the anus.

Fistula-In-Ano occurs when the perianal skin (skin around the anal region) forms an abnormal connection with the surface of the anal canal.

Most of the people confuse between the three, due to the similarity in certain symptoms. Any of these conditions is mistaken to be piles and thought be treated by piles surgery. It is due to the lack of knowledge of the disease, their causes, and their physical symptoms.
All these conditions, if not taken seriously can actually have a lot of impact on one’s lifestyle and routine.


Piles are caused due to the following factors:

  • Straining during a bowel movement
  • Complication from chronic constipation
  • Family history of piles
  • Sitting in the toilet for long

Fissures can be caused due to:

  • Straining during bowel movement or childbirth
  • A fall in the blood flow to the anal region
  • Inflammatory bowel disease
  • Spastic anal sphincter muscles
  • In rare cases, it can occur due to anal cancer, HIV, tuberculosis, syphilis, or herpes

An anal fistula can occur due to:

  • Crohn’s disease
  • Tuberculosis
  • Radiation
  • Obesity
  • Trauma
  • Sexually transmitted disease
  • Diverticulosis
  • Cancer

Most of the causes of these three conditions overlap, and so is their occurrence. Consultation with a doctor is essential to go ahead with the right treatment plan.


Piles in its early stages can be treated by medications. The patient is also advised to increase the liquid intake and fibers in
the diet. This prevents constipation which can ease piles and even help recover.
In the chronic cases where the piles get irritated or infected, piles surgery may be required.there are different surgical options to treat piles. The aim of piles surgery is to restrict the blood supply or remove hemorrhoids.

Fissures in their early stage is treated with medication and dietary changes, just as in the case of piles treatment. In cases where the anal fissures fail to respond to other treatment, lateral sphincterotomy is advised.

For anal fistula, surgery is the only option. It is performed by the anal and rectal surgeon.

Like piles surgery and lateral sphincterotomy are done in the later stages of the treatment of piles and fissure, it is not the case with fistula treatment. There are various surgical procedures that are performed to treat an anal fistula.