Why it happens:
Swollen veins (cushions) in or around the anus caused by constipation, straining, pregnancy, obesity, or prolonged sitting.
Symptoms:
Diagnosis:
Physical exam, anoscopy, or proctoscopy to determine the grade (1–4).
Treatment: see Haemorrhoids file for all treatment options....
Why it happens:
A small tear in the anal lining, often from passing hard stools or chronic constipation.
Symptoms:
Diagnosis:
Visual examination by a specialist.
Treatment:
Why it happens: An abnormal tunnel forms between the anal canal and the skin, usually following an infection or abscess (90% result from non-specific cryptoglandular infection).
Symptoms:
Diagnosis:
Physical examination, MRI, or endoanal ultrasound.
Treatment:
Why it happens:
Small growths inside the anal canal, sometimes linked to inflammation or colon polyps. May carry a small risk of malignancy.
Symptoms:
Diagnosis:
Detected during proctoscopy, sigmoidoscopy, or colonoscopy.
Treatment:
Why it happens:
Soft, flesh-colored growths around the anus might develop due to viral infection [Herpes simplex virus, HPV Human Papilloma Virus, molluscum contagiosum, HIV] or anal contact. Sexually transmitted diseases need to be taken into account. Sometimes they are only residual external hemorrhoidal skin tags – therefore expert opinion needed to achieve differential diagnosis.
Symptoms:
Diagnosis:
Visual inspection during examination. Biopsy to exclude condyloma or other diseases. Dermatology opinion. Gynecology opinion if needed.
Treatment:
A painful collection of pus that forms due to infection in anal glands. Depending on the spread, it may extend into deeper spaces like ischiorectal or horseshoe configurations.
Why it happens:
Usually cryptoglandular infection, Crohn’s disease, or untreated anorectal inflammation.
Symptoms:
Treatment:
Urgent incision and drainage. Delayed treatment may lead to the formation of an anal fistula.
These two conditions are often confused, even in clinical settings.
A small tract under the skin near the coccyx, caused by trapped hair and chronic inflammation.
Symptoms:
An infected, pus-filled cavity in the same region.
Symptoms:
Treatment:
What it is:
A collection of pus caused by gland infection in the anal canal. It may spread into deeper spaces such as the ischiorectal or intersphincteric compartments.
Why it happens:
Usually due to cryptoglandular infections, Crohn’s disease, or untreated fissures.
Symptoms:
Treatment:
Urgent drainage is required. Failure to treat early can lead to chronic anal fistula formation.
Pilonidal Sinus & Pilonidal Abscess
Why confusion happens: Many patients (and even clinicians) confuse these two. A pilonidal sinus is a chronic condition, whereas a pilonidal abscess is an acute infection.
A small tunnel in the skin near the tailbone, caused by ingrown hair and inflammation.
Symptoms:
Pilonidal Abscess (Acute Condition)
A painful abscess filled with pus.
Symptoms:
Treatment for Both:
