Hemorrhoids often cause discomfort like pain or itching near the anal area, especially when sitting or during bowel movements. However, experiencing an irritated anus is not just a sign of hemorrhoids. Sometimes, this pain could be something else altogether – and it is important to be able to tell the difference.
If the pain comes from hemorrhoids, there is usually nothing much to worry about. Hemorrhoids, also known as piles, are swollen veins either in the rectum or around the walls of the anus. More often than not, they subside by themselves with home care. Only in some rare cases does a case of hemorrhoids become severe or have complications.
It is more worrying when pain around the anal area is a result of some other serious health issues. Here are some conditions that may include signs of pain and discomfort similar to hemorrhoid symptoms:
- Colorectal cancer: Colorectal cancer occurs in the lower intestine or rectum area, and sometimes causes bleeding which may be mistaken as a sign of hemorrhoids. While finding fresh red blood in the stools can point to either colorectal cancer or hemorrhoids, the presence of other symptoms can help to distinguish between them. If there are other digestive symptoms like stomach pain, change in bowel movements, bloated stomach, and unexplained weight loss, it is probably not just hemorrhoids you should be worrying about.
- Inflammatory bowel disease (IBD): IBD encompasses ulcerative colitis and Crohn’s disease, which can cause hemorrhoid-like symptoms like rectal bleeding and discomfort. These two conditions are chronic diseases, which means if you experience symptoms that persist for more than a few days, it may be one of these conditions rather than hemorrhoids. IBD may also be accompanied by abdominal cramping, diarrhoea, and fever.
- Anal fissures: Similar to hemorrhoids, anal fissures are localised conditions that directly affect the anal region. Anal fissures are small tears or cuts in the anal canal that can feel painful, with some experiencing a burning sensation. Bleeding may also occur. Often, the cause is over-straining due to constipation. Anal fissures are generally non-serious and can be treated much in the same way as hemorrhoids.
- Pruritus ani: Pruritus ani refers to anal itching and is a symptom rather than a condition by itself. However, it deserves a spot on the list as many people mistake anal itching for hemorrhoids. Feeling irritation and the urge to scratch the anus area can be caused by numerous conditions, such as psoriasis and fungal infection. Hemorrhoids, anal fissures, or the use of harsh soaps and irritants can also trigger itching.
- Genital warts: Caused by the human papillomavirus (HPV), genital warts are signs of a sexually transmitted disease (STD) that affects the genital and anal area. Bleeding, itching, and discomfort is common with genital warts and many other STDs. Unlike hemorrhoids which subside quite quickly, genital warts often get worse unless it receives medical attention.
Hemorrhoid-like symptoms alone may make it difficult to pinpoint the exact cause, but you can narrow down your condition by also assessing other accompanying symptoms and your risk factors for certain diseases.
When should you visit the doctor?
If you are unsure of what your anal discomfort is caused by, or if it is causing significant pain, a trip to the doctor is recommended to get a thorough examination of your symptoms. Additionally, you should consult a doctor if:
- there is heavy rectal bleeding
- symptoms do not subside within a few days
- there are other symptoms, e.g. fever, stomach pain, weight loss