In the field of medicine, it’s often taken for granted how common some conditions are, while others are much rarer in presentation. While you and your doctor may want to assume that anal itching and bleeding after a bowel movement is simply caused by hemorrhoids, it would be a disservice to not address other potential conditions. The likelihood may be lower, but patients should know what to look for.
Hemorrhoid Symptoms
Hemorrhoids are harmless, albeit painful, protrusions and swollen blood vessels that may be inside or outside of the anal sphincter. Hemorrhoids usually resolve on their own and don’t require treatment, and they rarely lead to infection or complications. Here are the symptoms of hemorrhoids:
Itching or burning around the anus.
Pain during a bowel movement, particularly at the anal opening.
Small amounts of bleeding during or after a bowel movement.
A sensitive lump around or inside the anal opening.
What Can Be Mistaken For Hemorrhoids?
There are some conditions related to hemorrhoids that can appear very similar, especially to the patient who is struggling with the symptoms. Here are a few conditions that are often mistaken as “just hemorrhoids.”
Anal Abscesses
This condition can be quite similar in appearance to hemorrhoids, but is fundamentally different. Anal abscesses are caused by swollen glands around the anus, often blocking up with pus and small amounts of blood. This condition can lead to anal fistulae and may require surgery to correct. The symptoms of anal abscesses are: constant pain and throbbing, pus discharge, fever, and chills.
Anal Fistula
If left untreated for long enough, anal abscesses can lead to the degredation of tissue surrounding the anal opening. This can cause tiny canals to form between the rectum and the outside of the body. Anal fistulae can usually be treated with surgery, and symptoms include: high fever, difficulty controlling bowel movements, and intense pain around the anus.
Anal Fissures
While this may sound incredibly terrible, anal fissures are actually more common than most people realize. This condition is characterized by a small cut in the sensitive mucous membrane lining the anal opening. If you’ve ever eaten a lot of popcorn, you have likely experienced small fissures the next day.
Anal fissures are generally nothing to get concerned about— unless they happen with no apparent cause: after a very hard stool, after a very large stool, or after a stool with sharp, fibrous pieces. Additionally, the symptoms for anal fissures are identical, except that the pain from fissures tends to last for a while after each bowel movement.
Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBDs) do exactly what the name suggests: your bowels become inflamed in response to some trigger. While the trigger might differ from individual to individual, it’s not uncommon for the inflammation and discomfort to extend all the way to the end of the digestive tract: the anus. If you have not yet been tested for the different IBDs, make sure to start logging your food intake, symptoms, and schedule an appointment with a gastroenterologist or colorectal specialist.
HPV Infection
Human papillomavirus can cause genital wart infections that are able to spread to the anus. If you suspect that you might be infected with HPV and you have symptoms similar to hemorrhoids, you should get tested for STDs and see a specialist about your symptoms. The symptoms of anal HPV warts include: growths around the anus that resemble cauliflower, mucousy discharge from the warts, and some bleeding around the anus.
It is important to note that viral HPV can also cause anal tumors to form, some of which can become cancerous. This is one of the reasons why discussing your probable hemorrhoids with your doctor is critical.
Is it Hemorrhoids or Something Else?
When in doubt, talk it out! It’s not the most engaging and exciting conversation to have with a doctor, but it could save you many months of pain and potentially your life. If you suspect that you might be struggling with hemorrhoids— or something bigger— reach out to our team of colorectal specialists at the Colorectal Clinic of Tampa Bay.