Piles (also called hemorrhoids) are pieces of tissue in the area between your anus and rectum that contain blood vessels. They are present in every single person. It's only when they are enlarged that they are considered abnormal.
Hemorrhoids are divided into:
1) Internal hemorrhoids
They are usually painless because the nerve fibres that supply them belong to the nerve supply of the intestine, which cannot be felt. An enlarged internal hemorrhoid may pull down the surrounding tissue and protrude from the anus. They can bleed, especially when hard stools injure the lining of the anal canal. Sometimes, they can prolapse, i.e. protrude from your anus.
2) External hemorrhoids
They can be felt as bulges at your anus. They are easily prey to blood clots, which can make them very painful. Sometimes, they may heal and leave a tag of skin protruding from the anus.
An anal fissure is a tear occurring in your anus area. It can be very painful during bowel movement especially when your stools are hard. It can cause bleeding and anal itching. If infected, there can be a smelly discharge of pus. Anal fissure are divided into Acute fissure and Chronic fissure.
Causes of Anal Fissures
- Constipation, due to the hard stools.
- Diarrhea, especially after repeated episodes.
- Insertion of an instrument e.g. thermometer, colonoscope or ultrasound probe, to examine the prostate.
- Childbirth.
- Other more serious causes e.g. infections, tuberculosis or anal cancer.
How to Treat Anal Fissures
- Take more fibre to prevent constipation.
- Drink more water.
- Avoid "sharp" foods like popcorn, nuts etc.
(Source: Pile or fissure? by Dr Y.L.M., Star2, 12 December 2012)
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