“Doctor, I should have hemorrhoids!” This is the first thing many patients say when they enter the anorectal clinic. After asking, there will be a variety of answers, “blood in the stool”, “pain in the anus”, “wiping doesn’t work”, “something came out of the anus, I have to stuff it back in “, “flesh ball on the side of the anus”, “painful lump in the anus”, “pus flowing from the anus”, “fluid flowing from the anus”, “painful lump in the anus”. fluid”, “unbearable anal itching”, “unable to pass stool or unable to finish”, “something blocking the anus, thinning of stool”, and “anal swelling, when standing for a long time, the anus feels like falling down”, “anus seems to be crawling with worms”, “more frequent stools”, “blood on wiping paper ” and so on. So many kinds of discomfort, all blamed on “hemorrhoids”, is it appropriate? Definitely not! Around the anorectum, there are many common diseases. What diseases should be considered for pain related to defecation? 1, anal fissure: pain is characterized by burning pain in the anal region at the beginning of defecation, more intense after defecation than before, and lasts for several minutes to several hours. 2, strangulated internal hemorrhoids: when defecating there is a swelling from the anus prolapse, can not retract, and the occurrence of severe and persistent pain, and a history of internal hemorrhoid prolapse. 3.Anal sinusitis: the pain is mild, often a few minutes after defecation, and can disappear on its own. What diseases should be considered for pain not related to defecation? 1.Perianal infection: persistent pain and increasing distension in the anus or anal canal, often accompanied by inflammatory manifestations, such as fever and elevated white blood cell count. 2.Thrombosed external hemorrhoid: The patient suddenly feels a spherical mass, purple or black, appearing at the edge of the anus, caused by the rupture of the perianal vein, accompanied by persistent and severe pain, which is aggravated when walking or standing. 3.Anal canal cancer: there is often mild persistent stinging pain in the anal area, and the general condition is poor in the late stage, and a hard lump can be felt in the anal canal. 4.Foreign body in the anal canal: such as chicken bone fragment, bamboo spur, fish bone spur, etc. enter the anal sinus and cannot be discharged, and the pain in the anal region is suddenly severe, persistent and worsens when defecating, and the patient usually does not have blood in the stool or inflammatory manifestations. The diagnosis can often be made by rectal examination (sometimes under local anesthesia). So, you can’t let “hemorrhoids” take all the “blame”. So many strange symptoms, which disease should they correspond to? Most anorectal discomfort is non-specific, and many diseases show similar or identical symptoms. However, patients are not aware that hemorrhoids are the cause of the discomfort at the anus that affects bowel movements, and can be misled into having hemorrhoid surgery because of such symptoms, which do not alleviate symptoms after surgery and make psychological anxiety heavier, causing more and more permanent pain. Anal pain is also common, is it the cause of hemorrhoids? Anal pain caused by hemorrhoids is seen in thrombosed hemorrhoids, inflammatory external hemorrhoids, and external hemorrhoid edema and hematoma from a chain of prolapsed internal hemorrhoids. Anal pain can be caused by perianal infection followed by perianal abscess, anal fistula, functional anal neuralgia, chronic anal pain, anal sinusitis, anorectal foreign body injury, and post-anorectal surgery. The most common type of anal pain is caused by anal fissures. Acute anal fissures are painful and tear-like during defecation. Old anal fissures are painful periodically, with pain during defecation, followed by relief, and continued distension and throbbing pain due to sphincter spasm starting after half an hour. Constipation, are hemorrhoids blocking the anus? Hemorrhoids are dilated and flexed downward mucosal vascular cushions under the skin of rectal mucosa and anal canal. Long bowel movements, expansion of blood vessels in hemorrhoids and downward movement of perianal muscles can cause blockage and a feeling of incomplete defecation. Constipation, divided into organic and functional, functional constipation is related to intestinal transport dynamics and rectal-anal detrusor reflex, slow transmission and outlet obstructive constipation. Exit obstructive constipation is a defecation disorder caused by anorectal and pelvic floor muscle incoordination and rectal mucosal prolapse and rectal protrusion. It is mostly seen in elderly, postpartum women or patients with habitual constipation, with straining to defecate, a feeling of incompleteness or dropping, and an inability to pass stool when there is an urge to do so. What are the causes of anal bloating? Hemorrhoids can cause anal swelling, but there are more obvious symptoms that occur before, such as external hemorrhoids with greenish-purple blood clots, external hemorrhoids with edema, and internal hemorrhoids that prolapse and are difficult to return to the anus. Anal swelling, moreover, is a non-specific symptom that can be triggered by a variety of etiologies. For example, anal sinusitis, functional anorectal pain, anorectal inflammation and abscess, rectal mucosal prolapse, pelvic inflammatory disease or posterior uterine tilt, prostatitis or hyperplasia, caecal lesions (presacral cysts), rectal colon tumors, etc. These diseases need to be treated after detailed examination to confirm the diagnosis. Why do I have a lot of stools? There are frequent stools due to irritation from swollen and painful episodes of hemorrhoids. Irritable bowel syndrome and inflammatory bowel disease are routinely considered. Combine this with other symptoms such as unformed stools, interspersed with mucous jelly or even bloody mucus, and occasional abdominal pain. In these cases, the patient should be advised to undergo a colonoscopy to confirm the diagnosis. What is this “crawling” or “anthroposis” feeling? The most important thing is to relax and divert your attention. Don’t be fooled by the saying “nine out of ten hemorrhoids”. If you have an appeal, don’t blame the hemorrhoids and rush to surgery to deal with them, you can’t easily deal with the flesh that grows silently in and out of the anus and the growth of blood vessels, some trouble is not caused by them, don’t toss them and end up causing more psychological and physical discomfort. Adjust the psychological state, improve dietary habits and living habits, professional doctors detailed examination to confirm the diagnosis, and then for different diseases, appropriate drug treatment, comprehensive treatment.