There are many reasons for anal pain, not necessarily hemorrhoids, specifically the following reasons: the first, a common cause may be anal fissures, long-term dry stools tend to damage the skin around the anal canal and cause pain, so the stool will lead to spasmodic contraction of the internal anal sphincter, which causes pain. Secondly, if there is a history of foreign body invasion or squatting or striking, sometimes it will lead to perianal pain. Third, if you drink a lot of alcohol or eat a lot of pepper and other irritating foods, it can lead to itching and discomfort around the anus, and can also stimulate the hemorrhoidal vein mass, which can cause congestion and pain. Fourth, it is possible for the anal glands to become infected and spread along the anal canal to the perianal skin to form an abscess, which can also cause severe pain around the anus. The fifth, if the hemorrhoid forms a blood clot or prolapses out of the anus for a longer period of time, and becomes embedded and forms necrosis, it can also cause pain. So there are many causes of anal pain, and we should combine medical history, physical examination and, if necessary, anoscopy to clarify the cause.