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Piles And Anal Fissure - Know the Difference

Dr. Vaibhav Kapoor's 90% (31 ratings)
MBBS, MS - General Surgery, FIAGES
General Surgeon, Gurgaon
Piles And Anal Fissure - Know the Difference

People generally are not aware of the diseases till they themselves suffer from them. Piles and anal fissures are two different ailments affecting the anal canal and lower rectum. If you are feeling pain in lower rectum or near the anus or if you are having complaints of bleeding while bowel moments, you might be suffering from piles/ haemorrhoids or analj fissure. Symptoms may be same so patients are genrerally not be able to decide whether it is pile or fissure. Only a doctor may diagnose the problems, causes and may render accurate treatments thereof.

What is piles or haemorrhoids-

Piles are referred as the swollen or inflamed veins in the lower parts of the anus or rectum. Piles may involve swollen blood vessels near the anus forming protrusion to the outside.

What is anal fissure?

An anal fissure is a small or thin cut in the lining of the anal opening. It may cause bleeding, pain and discomfort while straining or bowel movement. It may occur while passing hard stools during bowel movements. It may affect people of any age.

Both the conditions may lead to itching or inability to sit down comfortably. Such problem may make your life miserable and situations may become intolerable many of the times. Sometimes, unawareness may lead to the seriousness of the disease. He or she may open up before the specialist at a later stage when problems can be treated with surgery only. Often traditional methods may fail to recover the situations. Whenever you are suffering from any anorectal problems, one needs to take experts advise and get diagnosed at the real time.


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How Effective Are Laser Treatment For Piles?

Dr. Vaibhav Kapoor's 90% (31 ratings)
MBBS, MS - General Surgery, FIAGES
General Surgeon, Gurgaon

Changing lifestyles and home remedies are not enough to comfort painful hemorrhoids or piles. When someone has crossed years of discomfort, surgery is the only option to treat the piles. Even surgery is also available in two options traditional methods like open haemorrhoidectomy and new advanced modalities like laser treatment.


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Haemorrhoids - Causes, Symptoms, Treatment, Prevention

Dr. Kinker. Mrinal 84% (10 ratings)
MBBS, MS - General Surgery
General Surgeon, Kota
Haemorrhoids - Causes, Symptoms, Treatment, Prevention

Haemorrhoids (also known as piles) are swollen and inflamed veins in the rectum or anus. Typical symptoms are pain, itching and bleeding around the anal area. Treatment and prevention will often involve non-prescription ointments, other home treatments and lifestyle changes. Haemorrhoids that don’t clear up may require a visit to your doctor and, in some cases, minor surgery.


Haemorrhoids are caused by an increase in pressure in the lower rectum from: 

  • straining during bowel movements
  • sitting for long periods of time, especially on the toilet
  • chronic (long lasting) constipation or diarrhoea
  • being overweight or obese
  • pregnancy
  • anal intercourse
  • low-fibre diet
  • spinal cord injury
  • poor posture.

Haemorrhoids are common and occur in most people at some stage during their lives. They tend to occur more frequently later in life due to age-related weakening and stretching of the tissues supporting the veins in the rectum. 

Signs and symptoms

Symptoms often depend on whether a haemorrhoid is located on the inside or outside of the body. 

Internal haemorrhoids lie inside the rectum and usually do not cause discomfort. However, straining or irritation when passing a stool can damage the surface of a haemorrhoid causing it to bleed. Sometimes, straining can push an internal haemorrhoid through the anal opening resulting in a protruding or prolapsed haemorrhoid, which can cause pain and irritation. 

External haemorrhoids lie under the skin around the anus. When irritated they can itch or bleed. Blood can pool inside an external haemorrhoid and form a clot, which causes severe pain, swelling, and inflammation.

Signs and symptoms of haemorrhoids may include: 

  • pain or discomfort, especially when sitting
  • pain during bowel movements
  • itching or irritation around the anal region
  • bright red blood on your stools, toilet paper or in the toilet bowl
  • swelling around the anus
  • one or more lumps near the anus, which might be tender or painful.

Bleeding during bowel movements is the most common sign of haemorrhoids. Rectal bleeding can, however, indicate a more serious condition, such as bowel cancer or anal cancer.  You should consult your doctor if your haemorrhoids:

  • bleed frequently or excessively
  • do not respond to self-treatment
  • if haemorrhoid symptoms have been accompanied by an obvious change in bowel habits
  • if you are passing black or maroon-coloured stools
  • blood clots have formed
  • blood is mixed in with the stool.


 A visual inspection should allow your physician to see if you have external haemorrhoids. 

Tests and procedures to diagnose internal haemorrhoids may include: 

  • a digital rectal examination in which your doctor inserts a lubricated gloved finger into your rectum to feel for anything unusual, such as growths
  • a visual inspection of the inside of your anal canal and rectum using a viewing device such as an anoscope, proctoscope or sigmoidscope
  • a colonoscopy may be performed to do a more extensive examination of your entire bowel (colon) if your signs and symptoms suggest that you might have another digestive system disease, or if you have risk factors for colorectal cancer


Most cases of haemorrhoids can be self-treated. More serious or repeat cases may require medication or a surgical procedure. Haemorrhoids can recur after treatment; hence, they are controlled rather than cured. 


Home treatment is often all that is required to relieve mild pain, swelling, and inflammation associated with haemorrhoids. Home treatments include: 

  • use of non-prescription haemorrhoid ointments, creams, suppositories, or pads containing a mild corticosteroid, e.g. hydrocortisone, or witch hazel extract
  • soak the anal area in warm water for 10 to 15 minutes two or three times a day
  • use stool softeners, which help stools to be passed more easily
  • ensure that the anal area is kept clean by bathing or showering daily – soap is not necessary and the affected area can be dried with a hair dryer
  • use moist towelettes or wet toilet paper (that do not contain perfume or alcohol) rather than dry toilet paper, to help keep the anal area clean after passing a stool
  • applying ice packs or cold compresses on the affected area can relieve swelling
  • taking oral pain medication, such as paracetamol or ibuprofen, can help to relieve discomfort.

Non-surgical and surgical procedures 

For an external haemorrhoid in which a clot has formed, prompt relief can be obtained from your doctor performing a simple incision to remove the clot. 

For persistent bleeding or painful haemorrhoids, the following non-surgical procedures to destroy the haemorrhoid can be performed in a doctor’s office:

  • rubber band ligation, involves using a rubber band to cut off the blood supply to the haemorrhoid causing it to shrivel and die
  • injection (sclerotherapy), involves injecting a substance into the haemorrhoid to make it harden and shrink
  • laser or infrared coagulation, which is a type of heat treatment that causes the haemorrhoid to harden and shrivel.
  • If non-surgical procedures are not successful or if the haemorrhoids are particularly large, one of the following surgical procedures may be necessary:
  • haemorrhoidectomy - removal of a haemorrhoid with a scalpel or laser
  • haemorrhoid stapling - removal of a haemorrhoid with a special staple gun that also inserts a ring of staples to close the wound and prevent bleeding. 


Keeping your stools soft is the best way to prevent haemorrhoids from occurring. The following steps can help to prevent haemorrhoids from occurring and reduce symptoms of existing haemorrhoids:

  • eat high-fibre foods
  • drink plenty of fluids
  • consider using fibre supplements
  • avoid straining when on the toilet
  • go to the toilet as soon as you feel the urge
  • get plenty of exercise
  • avoid sitting for long periods.
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Women's Common Problems

Dr. Namrata Grover 91% (40 ratings)
M.A in Clinical psychology, B.A - Psychology
Psychologist, Faridabad
Women's Common Problems

Some common issues of women juggling with multiple roles are:

  • Floating anxiety
  • Stress of managing work
  • Inability to prioritize work and a piling list of “things to do”
  • Inability to fall asleep
  •  Constant complaint of fatigue and tiredness
  • Lack of interest sex
  •  Extreme feelings of guilt
  • Loss of self confidence


  • Have realistic expectations from self: even god can’t keep everyone happy.
  • Plan and be far sited: before taking up new role be sure and set expectations with your family.
  •  Seek help from family and spouse: it’s ok to ask your spouse to help. Don’t except that they will understand.
  • Nurture independence: ensure you family gains independence including your child, which will reduce your work.
  •  Take in your plate as much you can: communicate to your family how much you will be able to do. Be assertive.
  •  Don’t be ashamed of few things that you are unable to do.
  • Make your husband your best friend.
  •  Don’t be afraid to set your expectations from your family.
1 person found this helpful

Stress - A Silent Initiator Of Piles!

N.D.D.Y, Bachelor of Ayurveda, Medicine and Surgery (BAMS), specialist in ayurvedic ksharsutra therapy
Ayurveda, Delhi
Stress - A Silent Initiator Of Piles!

Stress affects the entire body functioning and leaves a negative effect in its wake. If you are prone to piles (hereditary) and are stressed out, watch out as it can only accelerate the occurrence of piles or haemorrhoids. It is a bunch of blood vessels in and around the anal region. These can get irritated due to constipation and excessive strain during bowel movement. The result is pain and bleeding. These could be internal or external, depending on whether it is protruding to the internal or external environment.

If you are wondering about the correlation between the two, read on:

  1. Some of the bowel disorders including irritable bowel syndrome and peptic ulcer are related to stress
  2. Stress leads to more consumption of junk and feel good foods, which all lead to constipation and haemorrhoids. The extra pressure during training directly leads to pressure on the anal region and haemorrhoid formation
  3. Stress prevents people from exercising and promotes prolonged sitting, which again leads to haemorrhoids
  4. Stress also leads to increased blood pressure, which can aggravate piles
  5. It has been observed that the severity of piles is more when the person is stressed than in normal period
  6. Alcohol again is consumed more during stress, and this can lead to dehydration, which in turn worsens piles


  1. Chronic constipation
  2. Smokers
  3. Genetic reasons
  4. Stress

Though they are initially painless, as they progress, they can lead to pain and bleeding.


Haemorrhoids can be managed through a multi-pronged approach. In genetically prone people, prevention through a fiber-rich diet is very useful and people who have developed it, treatment is required. Two techniques are widely used for treating piles.

  1. Kshar Sutra: This is an ancient Ayurvedic technique, wherein a linen thread is used to ligate the irritated and bleeding vessels to stop further bleeding. The linen thread is coated with herbs which have medicinal values (coagulating properties, anti-inflammatory, and anti-bacterial). This is left in place for a while to ensure the piles is cured. It is a minimally invasive procedure but should only be done by experts. It might require multiple sessions too, in people who have severe haemorrhoids and/or recurrence.
  2. Infrared rays: With light rays being used for multiple medicinal uses, clotting and ligating blood vessels is one of them. In piles, a beam of infrared rays of a specific wavelength are directed at haemorrhoid. This coagulates the blood vessels, and as there is no further blood supply to haemorrhoid, further growth is arrested. There is a scar tissue left behind which ensures further bleeding does not happen. This is done only for internal hemorrhoid, and each hemorrhoid is treated separately.

Ayurvedic Treatment of Piles:

Often Nagakesara is recommended by Ayurvedic doctors, especially when this is associated with bleeding. One teaspoon-full powder of Nagakesara is given to the patients three times a day. Haritaki is a useful herb for both dry and bleeding piles. One teaspoon full powder of Haritaki is given to the patients two to three times a day.

Ayurvedic drug Abhayarishta is a widely recommended medicine for this condition. 30 ml of Abhayarishta is given to the patient twice daily after food with an equal amount of water. Kasiaditaila can be used externally, which helps in shrinking piles and cures itching in the anal region. It helps in relieving pain and checks bleeding.


Avoid any fast food and spicy items. Take foods which are rich in fiber. Barley, wheat, old rice, goat’s milk, brinjal, etc. are recommended food for the patient. Take sufficient water. Little warm water is sometimes recommended.

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Food Precautions And Routine For Piles Patients

Dr. Kinker. M 84% (10 ratings)
MBBS, MS - General Surgery
General Surgeon, Kota
Food Precautions And Routine For Piles Patients
  1. Stop using any tea/coffee completely. No out side hot/cold Beverages.
  2. Do not use sour taste items (Tamarind, Lemons, Pickles, Tomatoes, Curds, oranges, citrus, Vinegar etc.) in your food.
  3. Non-Vegetarian food even eggs are completely restricted.
  4. No Chilies in any form (Red, green, Chili powder and raw) and spicy food.
  5. No deep-fried and oily food best preffred is boiled food.
  6. No Heavy pulses i.e. Black Grams (Urd), Kidney Grams (Rajmaha), Lobia Etc.
  7. Drinking is strictely prohibited in any case, smoking and chewing of any tobacco items have to be avoided.
  8. No heavy exercises i.e. weight lifting, but a complete bed rest is not required.
  9. Avoid long journey, sitting/drivingriding for long hours, after every 1 hour session please have a 10 minutes walk and no late night working or awakening.

What to use: (Compulsory)

  1. Drink lots of water (4-5) liters in a day)
  2. Drink radish juice 50-100 ml thrice in a day. (mandatory). Eat radishes and carrots compulsory in your food or as salad.
  3. Use light and liquid food as Moong Dal (Green Grams) , Arahar dal(Yellow dal) , rice etc.
  4. Suggested Food routine:
    Breakfast: Have Daliya/Saviyan/Fruit salad/Upma/Poha /Idli etc.
    Lunch: Semi solid mixutre (khichddi) of Rice and Moong (Green Grams)in lunch.
    Dinner: Green Grams/Vegetables and rice/roti with a half spoon home made butter added to vegetable in dinner. All the preparation shall be with out spices, chilies and oil. Preferred to have boiled food.
  5. Take one spoon of Triphala powder or any other digestive enhancer with warm water or as per the prescriptions before going to sleep.
  6. Eat fiber rich fruits and vegetables i.e. Papaya, Fig,Watermelon, Pomegranate, Guava, etc.


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Piles: Why Should You Choose Homoeopathic Treatment for It?

Dr. Prabir Ganguly 89% (38 ratings)
Bachelor in Homoeopathic Medicine & Surgery (BHMS)
Homeopath, Dhanbad
Piles: Why Should You Choose Homoeopathic Treatment for It?

Piles or Haemorrhoids is a disease of the anal canal. The veins in this region get affected. They swell as blood stagnates inside them. This causes discomfort while passing stool. The most obvious symptoms of piles are bleeding and pain at the time of excretion or passing of the stool. For most of the patients with piles, sitting or standing becomes a tedious task.

What causes piles?
The primary reason behind the occurrence of piles is a patient’s sedentary lifestyle. Most of it also depends on upon his or her diet intake. Many of us consume a lot of carbohydrates, fats and proteins in our regular meals. But, we forget or are simply reluctant to take up physical exercises. This, in turn, leads to increase in body weight and hampers the activity of our digestive system. As a result, patients develop diseases like piles.

Diet plays a vital role in preventing piles. If we don’t add an adequate amount of fibre or roughage to our diet, there is a potential threat of developing piles. Fibres help with the convenient evacuation of the stool. In fact, fibres form the bulk of the stool. Besides, insufficient intake of water may also cause this disease.

Natural ways to tackle Piles
Piles can be managed or tackled by bringing in some changes in our lifestyle. Some of the ways of managing piles have been listed below:

  1. Add more roughage and fruits to your diet
  2. Exercise regularly
  3. Avoid laxatives
  4. Sit in a tub of hot water to get relief from the pain
  5. Drink plenty of water

Homoeopathic treatment for Piles
When it comes to the treatment of piles, Homeopathy is quite safe and an effective method to get rid of the problem. It doesn’t have any side effect on the patient’s health. It doesn’t include any painful surgery for removal of piles. Moreover, homoeopathy is budget-friendly. Homoeopathy deals with symptoms similarity. It is not disease-specific or drug-specific treatment. Here are some effective homoeopathic medicines, useful in curing piles:

  1. Hamamelis: This medicine is useful in stopping the bleeding in piles. It can cure any venous congestion and bleeding. It can also be taken when the patient develops a feeling of soreness.
  2. Ratanhia: It gives relief from the pain due to piles. A patient suffering from piles feels immense pain and a burning sensation at the time of stool evacuation and even for hours after that.
  3. Graphites: It is prescribed to a patient suffering from both constipation and piles. It is given to them who are obese, have skin eruptions and constipation.
  4. Nux Vomica: It is given to patients who have a sedentary lifestyle, take spicy food and are active smokers and alcohol drinkers. Usually, patients who have been advised to take Nux Vomica are aggressive in nature. It cures piles as well as digestive disorders.

Things to remember: These medicines are only some of the homoeopathic remedies available in the market. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

1890 people found this helpful

Common Anorectal Disorders - What You Need To Know?

Dr. Apoorv Goel 94% (1465 ratings)
MBBS, MS - General Surgery, FIAGES(Fellowship In Minimal Access Surgery), FMAS (Fellowship In Minimal Access Surgery)
General Surgeon, Ghaziabad
Common Anorectal Disorders - What You Need To Know?

Anorectal disorders are all the illnesses which are located in the anal and rectal portions of the large intestine. Hemorrhoids is an anorectal disease and so is anorectal cancer. While hemorrhoids are benign, anorectal cancer can be fatal.

Faecal incontinence, proctalgia fugax, excessive perineal descent, and pruritus ani, are other anorectal disorders which can affect men and women of all ages.

The symptoms of most anorectal disorders are nonspecific, that can make their diagnosis difficult. That is the reason anorectal disorders should not be taken lightly and treated a with priority. We bring you a snapshot of a few most common anorectal diseases for empowering you with knowledge so that you can stay healthy.

A few common anorectal disorders are:

1. Hemorrhoids: These are large, sack-like blood vessels which are located in and around the anus. These can also be found in the lower rectum or the portion of the large intestine just above the anus.
Causes: They are caused due to ageing, chronic constipation, diarrhea, pregnancy, not getting enough fibre and irregular eating habits.
Symptoms: Bleeding while defecation, pain and protrusion of the haemorrhoid and most of these do not respond well to non-surgical treatments such as increasing intake of dietary fibre and avoiding constipation. Surgical treatment is thus advised for patients who continue to have severe bleeding, pain or protrusion due to hemorrhoids. Treatments: Common surgical treatments for severe hemorrhoids are:
Rubber band ligation- This is an outpatient procedure.
Hemorrhoidectomy- This is a surgery to remove hemorrhoids and it is the best method for permanent removal of hemorrhoids. It may require hospitalization and a period of inactivity.

2. Anal Fissures: This is a small tear in the lining of the anus. Anal fissures cause pain, bleeding and itching around the anus.
Causes: Anal fissures are caused due to hard, dry stools, diarrhea and inflammation in the anorectal area.
Treatments: Most anal fissures heal by themselves over time. They can also be healed by application of medicated creams and topical ointments. Surgery is recommended when the fissures don’t heal.
Surgical options are:

  • Surgical repair: Repair of the anal tear.
  • Internal sphincterotomy: This consists of a small operation to relieve the underlying muscle spasm, which is actually contributing to the anal fissure.

3. Anorectal Abscesses: This is an infected cavity which is filled with pus and found near the anus or rectum.
Causes: Usually, such abscesses occur when bacteria or faecal matter enters the tissue outside the anus. 

Symptoms: â€‹Superficial anal abscesses are often associated with:

  • Pain, which is usually constant, throbbing, and worse when sitting down.
  • Skin irritation around the anus, including swelling, redness, and tenderness.
  • Discharge of pus.
  • Constipation or pain associated with bowel movements.

Treatment: The treatment of an abscess is surgical drainage under most circumstances.

4. Anal Fistula: Anal fistula is the name given to a small, abnormal tunnel connecting the anal glands. From this tunnel, the abscess comes out onto the skin outside the anus. Bowel diseases such as Crohn's disease and colitis are linked to an increase in the likelihood of anal abscesses and fistulas.
Symptoms: Pain, irritation of the skin around the anus, pus, fever and swelling.
Treatment: Usually involves surgically draining pus from the infected cavity and, also making an opening in the skin near the anus for removing the pus cells.
Fistulotomy: This is a surgical treatment to cure anal fistula. and can be performed on an outpatient.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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Piles - What Type Of Surgical Options Are Available?

Dr. Sandeep Agarwal 89% (25 ratings)
MBBS, MS - General Surgery
General Surgeon, Pune
Piles - What Type Of Surgical Options Are Available?

For some people, lifestyle changes along with a healthy diet cannot do the needful when it comes to hemorrhoids, commonly referred to as piles. There are numerous options like the laser that can shrink the swelling and inflammation in non-invasive ways. But even though it takes lesser time and involves much lesser complications, surgical intervention can be the best way to achieve a long-term solution. It is particularly suitable for those who are suffering from intolerable pain and discomfort along with occasional bleeding.

What are the different surgical options for treating piles?
Surgery is the best way to treat piles in those who have failed to recover through other modes of treatment. In other words, you should consider getting piles surgery done in case you have hemorrhoids that cannot be treated through non-surgical means. There are numerous surgical options available for piles, and the primary types are mentioned below:

Hemorrhoidal artery ligation: This operation is used for reducing the flow of blood to the hemorrhoids. It is normally carried under general anesthesia while a tiny ultrasound probe is inserted into the anus. The probe then produces high-frequency sound waves which let the surgeon detect the vessels that are supplying blood to the affected area. Each of these vessels is stitched for blocking the supply of blood to the piles that eventually leads to shrinkage after a few days or a week. It is also suitable for treating hemorrhoids that prolapse and hang down from the anus.

According to the National Institute for Health and Care Excellence, the hemorrhoidal artery ligation is an effective procedure which can be used for treating piles. It causes lesser pain than other surgical options, and a higher level of satisfaction has been reported as well. The recovery time is also shorter in the case of hemorrhoidal artery ligation. There is minimal risk of bleeding and pain while passing stools and there is little chance of hemorrhoid prolapsing after this procedure. It can thus be concluded that this process is best suited for most people suffering from hemorrhoids.

Hemorrhoidectomy: This is yet another way of treating hemorrhoids through surgical intervention. It is typically carried out under general anesthesia which indicates that you will be unconscious during the entire procedure and won’t feel any pain or discomfort. A conventional process of hemorrhoidectomy involves opening up of the anus to scrape out the hemorrhoids. It takes about a week or two to recover from the process, and you are likely to experience a significant amount of pain after the process. Even though you will be given painkillers, it is important to consult an expert if the pain continues for a long span of time.

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Causes and Symptoms of Piles

Dr. Satish Sawale 91% (1766 ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS), PG Dip Panchakarma, PG Dip Ksharsutra for piles,pilonidal sinus and fistula management , Post Graduate Diploma In Hospital Administration (PGDHA), Certificate in Diabetes update
Ayurveda, Navi Mumbai
Causes and Symptoms of Piles

Piles, which are also called hemorrhoids, refer to the swelling of the veins near the anus and rectum, which get irritated during bowel movements, causing pain and bleeding during stool motions. The veins near the rectum or the anus may rupture during strained bowel movements and thus, cause the blood to come out with the stool. This can be very painful for the patient and has a very disruptive effect on their lives.

Causes of Piles

There may be many causes for piles or hemorrhoids and the cause may vary from patient to patient. Let's have a look at a few of them.

  • Straining when passing a stool - This is by far the most common reason for piles and this is what causes the irritation on the veins or causes them to rupture
  • Chronic Constipation - People suffering from chronic constipation due to gastrointestinal problems may also suffer from piles due to putting pressure constantly to relieve themselves.
  • Lifting a heavy weight or doing strenuous work - This can also put physical stress on the anus or rectum and cause swollen veins, which may then rupture during the passage of stool.
  • Pregnancy - Pregnancy causes many hormonal changes in the body and the strain may also result in piles.

Symptoms of Piles

Some of the symptoms of piles or hemorrhoids are:

  • Painful bowel movements, which hurt the rectum or the anus, accompanied by general tenderness within the region
  • Bleeding or seeping of a bright red color blood onto the stool on the toilet or even on toilet paper
  • Itching in the anal areas, which may be continuous or intermittent
  • A swelling or lump near the anus, which is painful
  • A mucus-like discharge from the anus

There may be one or more factors present in particular cases and if there is a pain in the rectal area, it is best to get it checked out by a doctor as soon as possible.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3267 people found this helpful