The reason for the perianal swelling is not necessarily hemorrhoids: 1. There are four stages of hemorrhoids, which can lead to swelling of the hemorrhoid nucleus and pathological hypertrophy of the anal cushion after constipation or alcohol consumption, thus moving down and out of the anus. If a patient has a hard mass around the anus, it may be a perianal abscess, which is hard, red, swollen, hot and painful, and can be clearly diagnosed with perianal ultrasound. 3. If a cauliflower-like swelling is visible around the anus, with an uneven surface, sometimes with erosion and bad odor, it may also be anal canal cancer, which requires a biopsy for pathological examination.