Piles, Fistula, and Fissure are three common medical conditions affecting the anal region, often causing discomfort and pain. Here's a brief overview of each:

Piles (Hemorrhoids): 

Piles, also known as hemorrhoids, are swollen and inflamed blood vessels in the lower rectum or anus. They can be internal (inside the rectum) or external (under the skin around the anus). Piles can result from increased pressure in the veins of the rectal area, often caused by straining during bowel movements, chronic constipation, or pregnancy. Symptoms of piles include pain, itching, bleeding during bowel movements, and a lump or swelling around the anus. 

Fistula: 

An anal fistula is an abnormal tunnel-like tract that forms between the inside of the anus or rectum and the skin around the anus. It typically occurs as a result of an infected anal gland or an abscess that didn't heal properly. The most common symptom of a fistula is persistent or recurrent drainage of pus or blood from an opening near the anus. Fistulas can cause pain, discomfort, and recurrent infections.

Fissure: 

An anal fissure is a small tear or cut in the lining of the anus, which can cause pain and bleeding during bowel movements. Fissures are commonly caused by passing hard or large stools, chronic constipation, or diarrhoea. The pain associated with anal fissures can be quite severe and may lead to spasm of the anal sphincter, making it difficult to pass stools.