Piles Or Fissures Or Fistula

Piles are caused by swollen veins inside or outside the anus. Anal fissure is an elongated ulcer in the long axis of the lower anal canal. Anal fistula is an abnormal passage formed rectum to the vagina.


  • Straining to evacuate stool in constipation.
  • Over purgation – Diarrhea of colitis, dysentery etc.
  • Low roughage diet.
  • Pregnancy.
  • Cancer of rectum.


  • Straining to urinate – in case of stricture of urethra or enlarged prostate (piles).
  • Hereditary tendency.
  • Sedentary life.
  • Obesity. Fistula/ fissure:
  • Granulomatous infection e.g. Crohn’s disease or Syphilis.


  • Bleeding from anus along with defecation.
  • Bleeding of bright red blood.
  • Blood and pain while defecating.
  • Blood streaked stools (fissures).
  • Drops of bright red blood after stools (piles).
  • Mucus discharge and itching.
  • Prolapse of piles – either it go back themselves or need to be replaced manually.
  • Sensation of incomplete evacuation of rectum.
  • Stools being evacuated from vagina (in case of anal fistula).


  • Treat the cause.
  • Avoid hot spicy and highly seasoned food.
  • Limit intake of fried and fatty food.
  • Have high fiber diet – whole grains, bran, oat, green leafy vegetables, peas, beans, potatoes, raw vegetables, salads, dried fruits and fresh fruits.
  • If possible stick to vegetarian diet.
  • Eat bitter gourd, black musale (Kali musli), Kareer (ker) are said to be beneficial.
  • Eat fruits and vegetables with the skin.
  • Drink sufficient water to avoid constipation.
  • Exercise.
  • In pregnancy do exercise under supervision of a professional.
  • If over-weight reduce weight.