Piles (haemorrhoids) and anal fissures are two of the most common yet most silently suffered anorectal conditions across the world. Many people hesitate to talk about these issues due to embarrassment, social stigma, or fear of medical procedures. As a result, patients often delay medical attention until the disease worsens, sometimes even after trying unqualified practitioners, home remedies, or harmful procedures.
Why Do People Hide These Conditions (Piles Hemorrhoids and Anal Fissures)?
Haemorrhoids and fissures are highly sensitive problems, and many individuals, even educated ones, feel uncomfortable discussing them openly. Most of the patients visit the clinics when the disease becomes complicated. Ignoring early symptoms, however, allows the disease to progress, increasing the risk of chronic bleeding, severe pain, recurrent swelling, and possible surgical intervention, including Barren Banding, Sclerotherapy, Fissurectomy for fissures and Hmeorrhoidectomy for piles.
Understanding Piles Haemorrhoids, and Anal Fissures
Piles and Fissures are both anorectal diseases, and their causes are almost identical, with the same symptoms for both, including pain and bleeding.
Piles (Haemorrhoids)
Piles are swollen veins inside or around the anal canal. They are primarily caused by constipation, straining during bowel movements, a sedentary lifestyle, weak digestion, and poor dietary habits. Piles are generally painless but cause itching around the anus and discomfort while sitting and defecating.
Anal Fissure
An anal fissure is a small tear in the lining of the anal canal, which is generally caused by hard stools. It typically occurs due to chronic constipation, trauma during bowel movement and tight sphincter muscles. A fissure causes sharp, cutting pain, often described as “glass-like” or “blade-like” pain during and after passing stool. The pain may last for several minutes to hours. Chronic fissures may develop a sentinel tag, making healing even more difficult.
Types of Piles
Haemorrhoids are classified into four grades based on their symptoms and clinical presentation.
Grade 1: Internal swelling, which doesn’t come out from the anus and occasionally bleeds.
Grade 2: Haemorrhoids prolapse during stool but return on their own after defecation and occasionally bleed.
Grade 3: Prolapse that must be pushed back manually; chances of bleeding are high.
Grade 4: Permanently prolapsed and bleeds; it’s a severe condition which requires surgery.
Two Broad Categories
Internal Haemorrhoids: Located inside; may bleed but often are painless
External Haemorrhoids: Swollen veins near the anal opening; bleeding and discomfort
Common Symptoms of Piles and Fissures
Although these two conditions are different, many symptoms can overlap. Understanding the signs can help in early diagnosis and timely treatment.
- Bleeding with Stool: Bright red blood on tissue or in the toilet bowl, piles are usually painless but painful bleeding in the fissure due to the open tear
- Pain During or After Passing Stool: Mild or no pain in early piles, severe “cutting or burning” pain in fissure
- Itching & Irritation: Mucus discharge and swelling often cause constant itching around the anus.
- Swelling or Lump: A soft, tender mass near the anus is common in piles. A painful skin tag may appear in chronic fissures.
- Difficulty Sitting for Long Hours: Office workers or drivers often struggle to sit continuously due to discomfort.
- Constipation & Hard Stool: This is the root cause of both diseases and worsens the symptoms rapidly.
- Fear of Going to the Toilet: Many fissure patients develop anxiety due to expected pain.
- Mucus Discharge: More common in piles; may cause foul smell or staining of underwear.
- Feeling of Incomplete Evacuation: Common in internal piles; patients feel the bowel is never fully empty.
- Burning Sensation After Toilet: A classic hallmark of fissure may last from 30 minutes to 2 hours.
- Poor Sleep & Emotional Stress: Chronic pain, embarrassment, and fear of bleeding lead to irritability and sleep disruption.
Why Do Piles and Fissures Occur?
The primary underlying issue is poor digestion and weak liver function, which leads to:
- Constipation
- Hard stool
- Increased pressure in the rectal veins
- Tear formation in the anal mucosa
Lifestyle factors such as prolonged sitting, lack of fibre, low water intake, spicy food, stress, and sedentary habits further worsen the condition.
Ayurvedic Approach: Safe and Effective Medicines
Ayurvedic treatment focuses on the temperament of the disease, the patients and the medicine. These medicines remove the causes and treat the disease by:
- Improving digestion
- Softening the stool
- Healing the mucosa
- Reducing inflammation
- Preventing recurrence
Three powerful Ayurvedic formulations commonly used are:
Livcon Capsule
Improves liver function, digestion & reduces internal inflammation. Recommended for:
- Early piles
- Bleeding piles
- Poor digestion
- Weak metabolism
Dosage: 1 capsule twice daily after meals and as per the Physician’s recommendations.
Manulex Churan
Relieves constipation and prevents hard stool. Recommended for:
- Chronic constipation
- Fissure prevention
- Internal piles
- Pressure and swelling
Dosage: 1–2 teaspoons at bedtime with lukewarm water.
Pymol Capsule
Purpose: Reduces pain, swelling, and burning, and helps in fissure healing. Recommended for:
- Acute fissure pain
- Swollen piles
- Burning sensation
Dosage: 1 capsule twice daily after meals.
Which Combination is Best for Your Condition?
Early Internal Piles (No Pain, No Bleeding): Livcon + Manulex
Bleeding Piles: Livcon + Manulex
Painful Fissure or Chronic Tear: Pymol + Manulex
Swollen Piles (Mass Prolapse): Pymol + Livcon
Severe Cases (Pain + Bleeding + Prolapse): Livcon + Pymol + Manulex
Recommended for at least 2 months, as per your Ayurvedic Doctor.
When is Surgery Required?
Ayurvedic treatment works effectively in Grade 1 and Grade 2 piles, and in early fissures. However, surgery becomes necessary when:
Piles Surgery (Stapled Hemorrhoidectomy) Recommended If:
- Grade 3 or 4 piles
- Mass remains outside permanently
- Excessive bleeding
- Thrombosed or complicated piles
Fissure Surgery (Lateral Internal Sphincterotomy / Fissurectomy) Recommended If:
- Severe pain persists beyond 6–8 weeks
- Sentinel tag develops
- No relief with medicines
- Recurrent bleeding
Always consult a qualified colorectal surgeon for any surgical procedure.
Prevention and Daily Care Tips
To prevent recurrence and support healing:
- Drink 2.5–3 litres of water daily
- Include high-fibre foods
- Oats
- Fruits (especially papaya)
- Green vegetables
- Whole grains
Avoid:
- Spicy food
- Deep-fried items
- Excess tea/coffee
- Prolonged sitting on the toilet
3. Take a 10-minute warm water (sitz bath) daily
- Avoid sitting for long hours
- Reduce two-wheeler use if symptoms worsen
- Exercise or walk 20–30 minutes daily
Final Thoughts
Piles Hemorrhoids and Anal Fissures can be extremely painful and emotionally draining, but early recognition and proper treatment can prevent complications. Ayurvedic medicines like Livcon, Manulex, and Pymol offer safe, long-term solutions when used correctly. However, severe or chronic cases should not be ignored and must be evaluated by a specialist. With the right lifestyle, diet, and medical guidance, most patients can recover fully and prevent recurrence.
