الفبرق بين الناسور والباسور والشق الشرجي من دكتورة دعد الطعانى افضل دكتورة بواسير فى دبي

Similar Symptoms… But Different Diagnosis and Treatment

Have you ever felt pain, itching, or bleeding in the anal area and didn’t know the cause? Many people experience these symptoms and assume they are due to hemorrhoids. However, the cause could also be an anal fissure or anal fistula. In this article, we explain the differences between these three conditions. We also discuss their causes, symptoms, and available treatments.

Hemorrhoids are swollen and irritated veins in the rectum or around the anus. They are often caused by chronic constipation, pregnancy, long periods of sitting, or a low-fiber diet.
An Anal Fissure happens when hard or frequent bowel movements cause a tear in the anal lining.
An Anal Fistula is an abnormal tunnel that forms, often after an infection or abscess near the anus.

Dr. Daad Al-Taani, a specialist in anorectal diseases, explains that many patients confuse these conditions. Their symptoms are similar, but the treatments are different. She stresses that a correct diagnosis is key to choosing the right solution and preventing recurrence.

Understanding Causes and Treatment Options

Hemorrhoids can often be treated with lifestyle changes, a high-fiber diet, and topical creams. In more advanced cases, rubber band ligation or laser therapy may be used.

Anal fissure is usually treated with stool softeners, pain-relieving ointments, or Botox injections. If the fissure doesn’t heal, a minor surgery might be necessary.

Anal fistula often require surgery. Treatments may include fistulotomy, laser therapy, or the LIFT procedure. The right choice depends on how complex the fistula is. It’s important to see a specialist to avoid complications.

To learn more about these conditions and modern treatments, visit Dr. Daad Al-Taani’s YouTube channel. You’ll find trusted medical advice in simple, easy-to-follow videos to help you understand your condition and take the right steps at the right time.

Hemorrhoids:

Hemorrhoids are swollen, distended veins that inflamed around anus or the lower part of your rectum. they lie under the mucous membranes lining the lowest part of the rectum and the anus.

There are two kinds:

  • External hemorrhoids, which develop under the skin around anus
  • Internal hemorrhoids, which occur in the lining of anus and lower rectum.
الفبرق بين الناسور والباسور والشق الشرجي من دكتورة دعد الطعانى افضل دكتورة بواسير فى دبي

Anal Fistula:

An anal fistula is an abnormal passageway, a small tunnel that develops between the end of the rectum and the skin near the opening of the anus. It is usually a side effect of an anal or perianal abscess, that drains pus from anus. The draining abscess can create a tunnel through anus to the skin outside.

the different types of anal fistulas:

1. Intersphincteric anal fistula: Passes through internal anal sphincter muscle.

2. Transsphincteric fistula: passes through both layers of anal sphincter muscles.

3. Suprasphincteric fistula: Passes through internal sphincter and then around external sphincter.

4. Extrasphincteric fistula: Goes around both sphincter muscles.

5. Superficial anal fistula: It appears in the lower part of the anal canal, bypassing the muscles.

Anal Fissure:

An anal fissure is an ulcer that develops in the lining of the large intestine, near the anus. it is a small tear in the tissue that lines the anal canal.

What is difference in causes between Anal fissure, Anal Fistula, and Hemorrhoids?

Hemorrhoids:

  • Chronic constipation or diarrhea.
  • Sitting for long time
  • A low fiber food
  • Pregnancy
  • Childbirth
  • Aging especially 45-65 years.

Anal Fistula:

  • Perianal abscess is the most common cause.
  • Inflammatory bowel diseases, like Crohn’s disease.
  • A traumatic injury in the anus.
  • A complication of previous surgery near the anus.
  • Radiation therapy in pelvic region.
  • Infection with tuberculosis.

Anal fissure:

  • Chronic or persistent diarrhea and constipation.
  • Pregnancy.
  • Childbirth.
  • Crohn’s disease.
  • Ulcerative colitis.

What about the Symptoms of each?

Hemorrhoids:

  • Anal pain
  • Anal Bleeding
  • Anal Itching
  • Prolapse, when the hemorrhoid falls out through the anal opening.

Anal Fistula:

  • Anal Pain
  • Anal bleeding
  • Cellulitis: an inflammation (redness and swelling) around and in the anus.
  • Irritation in the skin.
  • Smelly discharge.

Anal fissure:

  • Acute pain during and after bowel movement.
  • Bright anal bleeding
  • Skin tag near the anal fissure.

Now, what about treatments of each? Do all of them have same treatment?

Certainly not. Treatment varies from one case to another and from one diagnosis to another, even if the symptoms are similar. I will list the treatment for each of them separately.

Hemorrhoids:

In simple cases we can treat hemorrhoids by Conservative treatment:

  • Eat high fiber food
  • Drink plenty of water
  • Doing exercise regularly
  • Take pain relievers (paracetamol).
  • Creams or ointments for hemorrhoids contain hydrocortisone and lidocaine.

If the hemorrhoids are painful and the bleeding doesn’t stop, we treat hemorrhoids by non-surgical procedures:

  • Rubber band ligation
  • Sclerotherapy
  • Coagulation

but if we have an extreme hemorrhoid with/or large external skin tags, surgical treatment is recommended which called a hemorrhoidectomy.

Anal fistula:

Surgery: some anal fistulas will require surgery to fix and this depend on how simple or complex the fistula is the most effective way to treat Simple Fistula Which involves a small amount of muscles, is fistulotomy. In case we have a complex fistula which involves a large amount of muscles, We may use one of these:

  1. Laser and endoscopic treatment of fistula VAAFT, FILAC.
  2. Endorectal advancement flap.
  3. LIFT procedure (ligation of intersphincteric fistula tract).

Anal Fissure:

Acute anal fissure is treated by Non-surgical treatment:

  • Laxatives
  • High fiber diet
  • Drink water
  • Nitroglycerin which increases the blood flow to the area of fissure and helps in healing, in addition to relax the anal sphincter.
  • Lidocaine which relief pain.
  • Painkiller like ibuprofen.
  • Botox injection that paralyze the anal sphincter muscle and relax spasms.

In chronic anal fissure which doesn’t response to other treatments, or we have an anal fissure with extreme symptoms, surgery is recommended. it is called lateral internal sphincterotomy which involves removing a small piece of the anal sphincter muscle.

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