The first, more common is mixed hemorrhoids, especially internal hemorrhoids, internal hemorrhoids are varicose vein masses, usually when the abdominal pressure increases or constipation, resulting in swelling of the nucleus of the hemorrhoid, hemorrhoidal vein stasis and formation. If the local stasis is longer and the stagnation and swelling forms a thrombus, it is manifested as a hard swelling that can be touched on the inside of the anus and is painful inside the anus, which can be clearly diagnosed by rectal examination. Secondly, if there is submucosal abscess on the inner side of the anus, the anal gland infection spreads along the rectum afterwards, thus forming a rectal submucosal abscess, which is manifested as obvious submucosal fluctuation of the rectum, and can be clearly diagnosed by perianal ultrasound, which also manifests as pain on the inner side of the anus. Thirdly, if there is a fissure in the anorectum, long-term dry stool damages the skin of the anal canal, resulting in a fissure and pain in the inner anal canal when wiping the stool. Therefore, there are many causes of medial anal pain, and the diagnosis should be made based on medical history, rectal examination and, if necessary, anoscopy.