Causes of anal pain: fissure, abscess or thrombosed hemorrhoid?

How do common causes differ?

A fissure often hurts during and after passing stool; a thrombosed external hemorrhoid can cause a sudden painful lump; an abscess can cause progressively worsening pain with swelling or fever. Uncomplicated internal hemorrhoids alone do not usually explain severe continuous pain.

Can pain exist without a lump?

Yes. The cause may be deeper or involve pelvic-floor muscles. Functional pain requires an appropriate assessment; a normal-looking phone photograph is not enough to establish it.

Which test identifies the cause?

Examination guides the next step. Endoscopy or imaging is selected to answer a specific question, rather than ordering every test. Mention previous surgery, bowel inflammation, injury and associated urinary or genital symptoms.

When should online comparison stop?

Worsening pain with fever, swelling or systemic illness needs urgent examination. Recurrent pain without acute warning signs still warrants a planned assessment instead of repeatedly changing creams.

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