Pain/ Bleeding/ Pus discharge from anus – is it PILES?


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It is a common practice to name all the health problems related to anus as Piles/ Hemorrhoids irrespective of the complaint of the person like pain/ bleeding/ pus discharge. Is it really so or are there other health problems also which affect the anus and its surrounding area? We will try to answer this question in this article:

Pain in anus: It is one of the main complaint for which patient seeks help from a doctor. Pain might be continuous in nature or it might be associated with the bowel movement. Some times it may be accompanied by some bleeding also etc. Accordingly the diagnosis will be different in different conditions:

  • Fissure-in-Ano: When patient experience pain while passing stool which persists for some time after defecation or whole day; most likely it is because of Fissure-in-Ano. Pain is cutting in nature. Some times pain due to Fissure-in-Ano is so severe that patient stops eating in an attempt to avoid defecation. Fissure-in-Ano is a cut injury in the anal skin mostly due to passage of hard stool and some times repeated bowel movements.
  • Perianal Abscess: When someone is experiencing continuous pain which might be aggravated by passage of stool and its severity decreases after bowel movement. Pain is throbbing in nature with some swelling near anal opening. It might be accompanied by fever. Then most likely the fellow is suffering from Perianal abscess. It is an abscess developed near anal opening due to infection in anal glands. If it is not treated in time it may progress to Fistula-in-Ano.
  • Fistula-in-Ano: When patient experiences off and on pain with intermittent swelling in the area surrounding the anus with off and on discharge from the swelling or anal opening then most likely he is suffering from Fistula-in-Ano. Fistula-in-Ano is a abnormal tunnel like structure which connects skin with the interior of anus.
  • Ulcerative colitis: When patient complains of repeated bowel movements with pain in anal region and bleeding with pain in abdomen, fatigue and weight loss; most likely he is suffering from ulcerative colitis. Ulcerative colitis is an inflammatory bowel disease which causes inflammation and ulcers in the digestive tract.
  • Fungal infection in skin surrounding anus: When patient is experience itching pain it might be because of the fungal infection in the skin around skin. It might be accompanied by small eruptions and watery discharge in that region.

Bleeding from Anal Region: Bleeding might be accompanied by pain or it might be without pain. It might be accompanied by constipation/ diarrhoea or some times there may only bleeding no feces.

  • Piles/ Hemorrhoids: When patient experiences painless bleeding during defecation most likely he is suffering from Piles. Some time patient is not aware about the bleeding and comes to know about it only when he looks in toilet sheet without flushing the feces. Piles are the engorged hemorrhoidal blood vessels which usually results from constipation, sitting for long in toilet and too much straining during defecation.
  • Fissure-in-Ano: When patient complaints of little bit bleeding while passing stool along with pain most likely it is Fissure-in-Ano. As said above Fissure-in-Ano is a cut injury in the anal region resulting from different reasons.
  • Ulcerative colitis: bleeding from anal region accompanied by diarrhoea, fatigue, weight loss etc. is most likely because of Ulcerative colitis. As said above it is an inflammatory condition of digestive tract with ulcers in it.
  • Anal Cancer: when a person feel constant desire for defecation i.e. all the times he feels that there is something inside rectum. There are chances that when he tries to pass stool only blood comes without any fecal matter; most likely he is suffering from Anal Cancer.

Mass protruding out per rectum: mass protruding out is another complaint for which patients seek help from a doctor. This mass may be there all the times or it might appear at the time of defecation and go back inside by itself or needed to be pushed back by hand.

  • Piles: When patients complains of the mass protruding out from anal opening which goes inside by itself or patient pushes it back inside along with history of painless bleeding during defecation; most likely he is suffering from Piles. Piles are the engorged hemorrhoidal blood vessels which bleed during defecation. If not treated in this stage; pile masses develop which come out during defecation. Patient may feel discomfort in anal region as long as the pile mass remains outside.
  • External Hemorrhoids: When patient complains of mass protruding out at the mouth of anus which remains out and it is painful. Usually there is history of too much straining during defecation or long travelling. External hemorrhoids are the swellings near anal opening which result from collection of blood which happens due to rupture of some blood vessels near anal opening which in turn results from straining or long sitting. 
  • Rectal prolapse: When a patient complains of mass coming out from the anus which does not go inside by itself. Patient is usually an old age person. Instead of; from some parts as in piles; this mass is coming from all around the anus. Rectal prolapse is a condition in which rectum loses its normal attachments inside the body allowing it to come out through anus thus turning it “inside out.”
  • Fissure-in-Ano with Sentinel tag: when Fissure-in-Ano is not treated in time; skin starts growing from the lower end of the fissure which is termed as Sentinel tag. This growth always remains outside. When fissure is active; there might be swelling in the tag and patient feels that the size of tag has increased which again reduces when there is healing in fissure.
  • Rectal polyp: When patient complains of something coming out of anus during defecation which may or may not go inside by itself and patient is a child; most likely it is a case of Anal Polyp. Anal Polyps are abnormal growths rising from the lining of the rectum.

Discharge from anus or in near by region: Discharge from anus or from a swelling in near by area is another health problem for which patient seeks for help from a doctor. Discharge varies in consistency from watery to pus. There might be some blood also along with.

  • Fistula-in-Ano: A patient complaining of intermittent discharge from a nodular swelling or an opening in area around the anus is most likely a case of Fistula-in-Ano. As said earlier; Fistula-in-Ano is an abnormal tunnel like structure connecting skin to interior of the rectum.
  • Perianal Abscess: Patient complaining of swelling near anal opening with pain which bursts spontaneously with pus discharge might be a case of Peri anal abscess. It is an abscess developed near anal opening due to infection in anal glands.
  • Piles/Hemorrhoids: when Pile mass is not reduced inside and it remains outside; it might give feeling of discharge. Usually this discharge is watery in consistency and patient complains of discharge on his undergarments.
  • Inflammatory bowel conditions like IBS/ Crohn’s disease: inflammatory bowel conditions might be accompanied by discharge.

In this article we tried to give some idea about different health condition which might affect a person. Usually all these are termed as Piles but actually it is not so as we saw above.

The sole purpose of this article is knowledge sharing and it is in no way a substitute for doctor’s advice. We recommend readers to seek medical help in case you are suffering from any of the symptoms listed above.

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