Piles, anal fissure and anal fistula · Guide
Piles, anal fissure and anal fistula explorer: guide
Show the back passage within the body, enter what the examination, proctoscopy or MRI report found, explain the treatment and share a matching picture sheet.
For patients and families
Look at the picture together
The picture opens with the whole body. Choose Pelvis, then Back passage close-up to see the rectum, the anal canal and the two rings of sphincter muscle that keep you in control. Part of the wall is cut away so you can see inside. View from below looks up at the opening. Drag to turn it and scroll or pinch to zoom.
Show what was found
Your clinician can show piles (haemorrhoids), a small tear (anal fissure) or a tunnel (anal fistula), as your examination, proctoscopy or MRI report describes them. For piles inside, the grade from 1 to 4 describes how far they come down. The places of the piles and the path of a fistula are an example. The slice in the corner is a schematic view of the opening from below. The shapes are not a copy of your examination or scan.
Things you could ask
“Can you show me where it is, and what the report found?”
“What would happen with each treatment, and how are the muscles protected?”
“What should I look out for at home?”
Take it home
Ask for a picture sheet with the views you discussed, your team’s explanation, what the back passage does and where to find help. A QR code reopens the same model settings on your phone. Names, notes and contact details are never included in that code or saved online.
For clinicians
Start with orientation
The explorer uses the rectum, anal canal, inner and outer sphincter muscles, pelvic floor and tailbone of the rectal explorer, on the same shared pelvic frame, body, renderer and labels. A cut-away on the patient’s right shows the inside of the canal, the front and the back. It opens at normal anatomy, with no findings or treatment.
Set up from the report
| Control | What to set |
|---|---|
| Findings on the model | Add findings. Changing any finding setting also adds them. |
| What was found | Piles (haemorrhoids), anal fissure (a small tear) or anal fistula (a tunnel). The settings and treatments shown change with the choice. |
| Piles: where | Inside (internal) or outside (external). Three internal cushions (in the usual left, right back and right front places) or two external lumps are drawn as an example. |
| Piles: grade | 1 to 4, for piles inside, as the report says. The number box and slider stay in step; the drawn piles come further down with each grade (grade 3 is drawn when they have come down). Entering a grade also sets piles inside. |
| Fissure: position and how long | Back (the most common place) or front, drawn there; short-term (acute) or long-term (chronic), drawn wider with a skin tag. |
| Fistula: type and abscess | Simple (low, crossing little or no sphincter muscle) or complex (crossing more of it), and whether an abscess is described. The tunnel is drawn at the back as an example; MRI shows the real path. |
Explain a selected plan
Only the treatments for the chosen finding are shown. Fibre, fluids and creams and Fibre, fluids and ointments that relax the muscle draw nothing extra and say that nothing is removed. Banding (piles inside only) colours the piles teal (area treated) with a band at each base; After treatment shows them gone. Operation to remove piles colours the piles teal (removed); afterwards the healing wounds are marked. Botox injection colours the inner sphincter teal; Small operation to relax the muscle colours a small part of the inner sphincter at the side, and its text states the small risk to control of wind or poo. Seton, Opening the tunnel and Other repairs for complex fistulas colour the tunnel teal; the seton is drawn as a loop of thread, the healed fistulotomy as a scar line, and the other repairs are described in words only. The texts say that protecting the muscles is a key part of choosing and that fistulas can come back. The team selects the plan; the model does not judge which treatment is suitable.
Picture sheet and QR code
Capture up to four views with Snapshot, then use Picture sheet (PDF). The sheet can include a help page with life after the treatment chosen. The QR link stores validated model settings only. Changing any model setting clears older snapshots.
Limits
- The body is an adult’s. The canal, muscles and pelvic floor are schematic, from the rectal explorer.
- The number and places of the piles, the length of a tear, and the place, path and branches of a fistula are examples. Clock-face positions, thrombosed piles, several fistulas, horseshoe tracks and the exact amount of muscle crossed are not modelled.
- Stapled and other piles operations, and complex fistula repairs (such as LIFT, advancement flaps, plugs and glue), are described in words, not drawn.
Sources and review
- NHS: piles (haemorrhoids)
- NHS: anal fissure
- NHS: anal fistula
- NICE Clinical Knowledge Summaries: haemorrhoids; anal fissure.
Practising colorectal surgeon review is still needed for clinical teaching use. Please send corrections through feedback.