Many patients are told that they have “anal papilloma” when they visit the doctor, and when they hear “tumor”, many of them are shocked. The most important thing is that it is not as dangerous as you might think. Today, we will take a brief look at “anal papilloma”. First, what is an anal papilla? The triangular yellowish-white papillae below the anal flap are called anal papillae, which are conical or triangular in shape and are remnants of the embryo, 3-8 in number, usually very small. The surface of the anal papilla is covered with smooth creamy white or light red skin and is arranged along the dentate line. So what is an anal papilloma? Most anal papillomas are caused by inflammation such as sinusitis and anal fissure, plus prolonged constipation, prolonged defecation, excessive force, or diarrhea, resulting in excessive stimulation of the anal papillae and hyperplasia, which over time will become hypertrophy or even anal papilloma. What are the symptoms of anal papilloma? How can they be distinguished from hemorrhoids? Anal papilloma is insidious in origin and slow in course. In the early stage, it is mainly a symptom of anal sinusitis or anal fissure: discomfort in the anus, a feeling of falling, stinging pain, and local irritation and burning pain when defecating. As the disease progresses, the papilla increases in size and causes a sensation of foreign body in the anus, a feeling of incomplete defecation, and a painful sensation when the enlarged papilla comes out of the anus during defecation, and occasionally blood in the stool. When the enlarged papillae are stimulated or broken, the secretion of anal glands will increase, resulting in dampness and itching around the anus, and over time, perianal eczema will develop. When a hypertrophic papilla prolapses outside the anus, it is often thought by the patient to be a prolapsed hemorrhoid and is often disregarded because it is not painful, does not bleed, etc. Needless to say, it is really hard to distinguish between the two when there is no expertise. Although the symptoms of a prolapsed papilla are similar to those of a prolapsed internal hemorrhoid, the traits are different. The prolapsed papilla is mostly brown or white, hard, not smooth, a small cone or triangular protrusion with a large head and a tip. The internal hemorrhoid is a bulging submucosal vein mass, which is mostly dark red, soft, smooth, and mostly round with no tip when it is not embedded. Some people also mistakenly call anal papilloma as “rectal polyp”, in fact, although the two look somewhat alike, but there is a fundamental difference, rectal polyps from the rectal mucosa, located in the middle and lower rectum, pink, soft, painless, and divided into neoplastic polyps and non-neoplastic polyps, neoplastic such as tubular adenoma, tubular villous adenoma, villous adenoma, etc. The neoplastic ones, such as tubular adenoma, tubular villous adenoma, villous adenoma, etc., are prone to malignant transformation; non-neoplastic polyps, including inflammatory polyps and hyperplastic polyps, are prone to bleeding. Anal papillomas are born near the dentate line, covered by skin, smooth, painful, less likely to bleed, and harder in texture. The shape of the enlarged anal papilla after hyperplasia can be bizarre and variable in length. In most cases, it is just a small cone or triangular protrusion, but when the disease is long, it may also evolve into various shapes on top of that, even like ginger. Can anal papillomas become malignant? The clinical treatment should be complete excision and pathological examination to avoid misdiagnosis and omission.