The anorectal department receives patients, “Hello, how do you feel uncomfortable”, “doctor, hemorrhoids ah” – many patients answer like this. If you continue to ask about the symptoms, you will find “itching at the anal opening”, “something at the anal opening, blocking the discharge of stool”, “anal swelling, can not stand for a long time, the anal opening is like falling down”, “itching at the anal opening”, “something at the anal opening, blocking the discharge of stool”. “It seems like there are worms crawling at the anal opening”, “frequent bowel movements”, “difficult to pass stool, thin stool”, “blood when wiping out “. Obviously, many people think that the problem that affects the discharge of stool and causes discomfort at the anus is hemorrhoids at work, and because such symptoms are misled to go for hemorrhoid surgery, there is no relief from the symptoms after surgery, aggravating the psychological anxiety and triggering more permanent pain. The actual fact is that you will find a lot of people who are not able to get a good deal on their own. causing more mental and physical discomfort. It is true that hemorrhoids have the symptoms of anal dampness and itching, but the anal dampness and itching caused by hemorrhoids has the prerequisite of more serious symptoms in the first place, that is, prolapsed internal hemorrhoids that cannot be retracted within the anus and mucous membrane erosions that break down and secrete mucus. Some dampness is also caused by another anorectal disease, anal fistula, where the outer opening of the fistula breaks down and keeps overflowing with pus leading to skin changes. The common anal dampness and itching is usually caused by perianal eczema, because the anus and perineum are in a “dark” place, and the living environment, climate change, and food can affect the occurrence of eczema. External stimuli such as humidity, cold, dryness, heat, hot water, and various animal hides, plants, cosmetics, soaps, and artificial fibers can trigger it. Internal factors such as chronic digestive diseases, mental stress, insomnia, overexertion, emotional changes, endocrine disorders, infections, and metabolic disorders are complex internal and external factors that cause a delayed metabolic reaction. The lesions of eczema are polymorphic, mainly erythema, papules and papules, with a central rash that is obvious and gradually spreads around, with unclear boundaries, diffuse, with a tendency to exude, or in chronic cases, with a rough surface and infiltrative hypertrophy. The course of the disease is irregular, with recurrent episodes and intense itching. The first step in treatment is to avoid stimulation, including dietary, psychological and nursing stimulation, followed by oral antihistamines and topical application of glyburide lotion or glucocorticoid creams. Hemorrhoids are soft venous masses and connective tissue hyperplasia caused by dilatation and flexion of the venous plexus under the mucous membrane at the end of the rectum and the skin of the anal canal, and many people think that their presence makes the anal opening smaller and blocks the discharge of stool, making it thinner. There is a type of constipation that is outlet obstructive and is most likely to be mistaken for hemorrhoids, but in fact it is due to muscle incoordination in the abdomen, anorectum and pelvic floor as well as prolapse of the rectal mucosa resulting in impaired fecal expulsion. It is common in elderly patients and is characterized by straining to defecate, a feeling of incompleteness or a feeling of falling, low defecation volume, and a desire or lack of desire to defecate; a lot of mud-like feces in the rectum on anorectal finger examination, and the external anal sphincter may be paradoxically contracted during forceful defecation, with the rectal mucosa accumulating in the anal canal. There is also slow-transmission constipation, which is caused by a weakened contractile movement of the intestine, slowing the movement of feces from the cecum to the rectum, or by the uncoordinated movement of the left hemicocele. It is characterized by reduced frequency of defecation, less bowel movement, hard stool, and thus difficult defecation; no stool or hard stool is palpated during anorectal examination, while the contraction and forceful defecation of the external anal sphincter function normally; the two types of constipation often occur together. The first treatment is to improve the psychological state and diet, followed by medication, taking all levels of laxatives, such as volumetric laxatives, lubricating laxatives, salt laxatives, osmotic laxatives, stimulating laxatives, prokinetic agents, followed by colon hydrotherapy, enemas, biofeedback therapy, and finally consider surgery. However, hemorrhoid surgery is not a definitive means of resolving outlet obstructive constipation. High stool frequency and functional problems are generally still considered irritable bowel syndrome, intestinal dysfunction. In addition, other symptoms should be combined with other symptoms, such as unformed stools, interspersed with mucous jelly or even bloody mucus, and occasional abdominal pain to exclude inflammatory bowel disease, and at this time the doctor always recommends that the patient undergo an endoscopy to further confirm the diagnosis. The diagnosis of enteritis or functional disorder is usually treated with medication. Hemorrhoids can cause anal swelling, but there are also more obvious symptoms that occur before, such as bruising and purple blood clots in external hemorrhoids, edema in external hemorrhoids, and internal hemorrhoids that prolapse and are difficult to retract into the anus. The symptom of anal swelling is a non-specific symptom, and there are many different etiologies that can cause anal swelling. For example, anal sinusitis, functional anorectal pain, anorectal inflammation and abscess, proctitis, rectal mucosal prolapse, pelvic inflammatory disease or posterior uterine tilt, prostatitis or hyperplasia, caudosacral lesions (presacral cysts), rectal colon tumors, etc. These diseases must be treated after further examination to confirm the diagnosis. The common cause of blood in stool symptoms is internal hemorrhoids or anal fissure, but other diseases such as proctitis, colitis, rectal polyps, colorectal tumors can also have blood in stool symptoms. Therefore, if you have appeal symptoms, come to the specialist clinic for detailed examination, if necessary colonoscopy (especially symptoms related to defecation), rectal and anal canal ultrasound, CT or MRI examination, combined with some other symptoms, to clarify the diagnosis of the disease. So, when you have appeal symptoms, don’t blame hemorrhoids and rush to deal with them surgically first, but adjust your psychological state, relax, improve your diet and living habits, and treat them with appropriate medication for different diseases, or comprehensive treatment.