Dilated blood vessels are the cause of haemorrhoid. The primary sign is bleeding, which is visible trickling down the toilet or toilet paper after using the restroom. While there may occasionally be some discomfort before, during, or after using the restroom, this discomfort is not continuous and usually disappears within a few hours to a day. Sometimes you may able to feel or touch a soft piece of “meat”, feeling something coming out from the anus when you defecate, or in certain condition you may need to push it back manually after pooping.
Anal fistula is different, the main symptom is pain. You may experience pain occasionally when you are sitting or pressing on it. Unlike haemorrhoid, you only feel pain when the haemorrhoid are at severe grade such as Grade 3 and Grade 4 haemorrhoid, in which the haemorrhoid already protruded/came out of the anal canal.
Patients may experience itchy skin and occasionally dermatitis as a result of the irritation by the active discharge/pus leaking from the fistula tract. Abscesses around the anus may appear as small lumps that are red, swollen, inflamed, and painful.