Anal pain and haemorrhoid pain are two very different symptoms. Most anal pain is caused by perianal disease, suggesting the possibility of an anal fistula, fissure or perianal infection. In contrast, haemorrhoids are an organic lesion that occurs in the rectum and at the end of the rectum, and the pain is confined to the haemorrhoid itself, and only when the pain is more intense does it involve pain in the surrounding tissues.