Mixed hemorrhoids and enlarged anal papillae are two very common anal conditions. Mixed hemorrhoids include internal and external hemorrhoids, which are mainly caused by varicose veins and downward migration of the anal cushion, while anal papillomegaly is mainly caused by repeated irritation from anal canal inflammation. If there are mixed hemorrhoids along with enlarged anal papillae, you can consider conservative treatment first. Pay attention to keep the bowel movement smooth, avoid forceful defecation, prolonged defecation, dry stool, anal cold, prolonged sitting and standing, pay attention to rest, avoid fatigue, and avoid all possible local stimulation of the anus. For hemorrhoids, if symptoms of blood in the stool exist, apply topical compound keratanate cream topically to the anus. If itching symptoms exist, insist on local anal fumigation sitz baths with hemorrhoid lotion. Anal papillomegaly can be treated conservatively if it is not accompanied by anal fissures.