Understanding The Difference Between Piles, Fissure and Fistula: Common Anorectal Conditions Explained Pain, bleeding, swelling or discomfort during bowel movements can create anxiety, especially when people are unsure whether the cause is piles, fissure or fistula. These conditions affect the anal and rectal area, but they are not the same. waiting for link from Web 2.0 Blogs (26)