How To Know The Difference?

Content

• Overview
• Hemorrhoids and anal warts causes
• Anal warts vs hemorrhoids symptoms
• Identifying anal warts vs hemorrhoids
• Treatments for anal warts vs hemorrhoids
• When to see a doctor for anal lesions or lumps?
• The lowdown

Determining whether an itchy or uncomfortable anal lump is anus warts vs hemorrhoids can be difficult. At the initial onset, when it is most important, the two can appear and feel quite similar. 

However, there are telling differences in both appearance and signs and symptoms. Because they have very different treatments, achieving clarity on whether you have anus warts or hemorrhoids is essential.

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The causes of hemorrhoids

Hemorrhoids, also known as piles, are swollen blood vessels in the anal canal. There are several types of hemorrhoids:

• Internal, located inside the anus

• External, located on or around the anus

• Prolapsed, when an internal hemorrhoid protrudes out of the anus, often due to strain

Hemorrhoids are thought to stem from repetitive straining related to chronic constipation or diarrhea, leading to the disruption of the supporting tissue elements with subsequent elongation, dilation, and engorgement of the hemorrhoidal tissues. Hemorrhoids occur more frequently in older populations.

The causes of anal warts

Anal warts (condylomata acuminata) are caused by human papillomavirus (HPV), a sexually transmitted disease (STD) that, depending on the type, can also lead to cancerous lesions. The warts initially appear as small spots that can grow large enough to cover the entire anus or genitals in rare cases. The growths are highly contagious and occur through direct contact with infected skin or mucosa.

What are the symptoms of hemorrhoids?

Pain and itching are common hemorrhoid symptoms, which can be unbearable, especially during bowel movements. Some are not painful, and because hemorrhoids can vary in location and type, the exact symptoms will also differ. 

Internal hemorrhoids are typically not painful unless they prolapse. However, they can bleed, causing bright red blood in one’s stool, in the toilet bowl, or on wiping.

What are the symptoms of anal warts?

One of the most common signs of anal warts is the presence of soft and moist pink or light-brown bumps that resemble cauliflower. Visible anogenital warts can ultimately enlarge, have rough surfaces, cluster, or become pedunculated. As they are often painless, it’s common for anal warts to go unnoticed, although they can be itchy. 

Left untreated, most anal warts resolve spontaneously, and treatment is not always indicated. However, rarely, some HPV infections may lead to genital cancers.

Because the treatments for anus warts and hemorrhoids are vastly different, it’s beneficial to identify them early on. 

Anal warts can easily spread, and it’s easier to prevent this when they’re small. Hemorrhoids are usually associated with minimal pain and can be treated easily. Both anal warts and hemorrhoids can bleed, making it difficult sometimes to differentiate between anal warts vs hemorrhoids.

Anal wart treatment includes creams and also liquid nitrogen, which may be painful on an already aggravated area. It’s important to receive an accurate diagnosis before treatment so you don’t use potentially aggravating anal warts treatments on hemorrhoids. 

The best way to be sure is to get a professional diagnosis, and an experienced physician can diagnose anal warts clinically. At times, they might perform a biopsy to confirm the diagnosis. Hemorrhoids can be diagnosed by physical examination as well. In either case, the doctor may use an anoscope (lighted scope) to check for internal anal warts or hemorrhoids.

What are the treatments for anal warts?

There are four main treatments for anal warts:

• Topical creams (Podofilox, Imiquimod, Sinecatechin)

• Cryotherapy (freezing them; administered by your doctor)

• Trichloro- or bichloroacetic acid administered by your doctor to burn the warts

• Surgical excision

The right treatment depends on the severity, size, and location of the anus warts. Generally, treatments for small and localized anal warts include applying a topical cream or liquid nitrogen, and about a third of anogenital warts regress without treatment within four months. 

For large anal warts or those deeper inside the anus, surgery is an option. The extent of the surgery determines whether the patient must be completely anesthetized or if the area can simply be numbed during the procedure. If there are many warts in different spots near the anus and in the rectum, the surgery may need to be performed in multiple stages. In any case, most anal wart surgeries require only a day in hospital, and usually no overnight hospital stay is necessary. 

Be aware that warts can return, and following up is very important. Human papillomavirus (HPV) may recur, creating new warts, especially if the area is inflamed or irritated or if the patient is immunocompromised.¹

What are the treatments for hemorrhoids?

Most hemorrhoids usually disappear on their own in a couple of weeks. Most treatments involve home care rather than treatment in a clinical setting. As they are enlarged blood vessels, one of the most important treatments for hemorrhoids is to reduce strain during defecation.

The main ways of reducing strain to the anus and rectal area are to avoid constipation by:

• Ensuring adequate hydration 

• Having a high fiber intake 

• Using laxatives if required 

Sitz baths are another common treatment option, which relax the anal muscles. Soothing wipes, especially those containing witch hazel or aloe vera, can also be helpful, as are over-the-counter creams or internal suppositories. The ingredients for both often contain hydrocortisone, an anti-inflammatory, and lidocaine, which numbs the area.

When prolapsed, the anal sphincter can cut off blood flow to hemorrhoids. This can cause tremendous pain, and some prolapsed hemorrhoids might require surgery. 

If hemorrhoids persist for longer than 7–10 days, it could be another issue, and you should seek a more accurate diagnosis.

To ensure proper treatment, confusion over anal warts vs hemorrhoids must be cleared up as early as possible. You should seek the appropriate therapies to either halt the spread of anal warts or, for hemorrhoids, begin soothing the enlarged blood vessels and reducing strain.

If you are certain it’s anal warts, consult your doctor for early diagnosis and treatment. For hemorrhoids, you can start by treating them at home — but if you experience other complications, you are advised to seek medical advice. Lumps that aren’t gone after a week and bleeding more than a few drops are signs to see a doctor. Other possible causes of anal lesions or lumps include rectal ulcers, fistulas, or other lower digestive tract issues.

At first, it can be hard to differentiate between anus warts vs hemorrhoids, as they both begin as small lumps in or around the anus. They can also both feel itchy, while hemorrhoids are more often painful (although not always). It’s easier to tell the difference when the condition has progressed, but by then, it may be much harder to treat.

Fortunately, there are several highly effective treatments for either condition. However, selecting the appropriate treatment requires differentiating between the two first.

Hemorrhoids, Anal Warts and Anal Fistulas

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Hemorrhoids, anal warts and anal fistulas are 3 different types of growths or spots that can appear in or around the opening of the anus. It’s important to learn the difference between these conditions, as treatment will vary.

Hemorrhoids Causes

Hemorrhoids are swollen veins in the lower rectum and anus. Hemorrhoids can form inside the rectum or under the skin by the anus.

What hemorrhoids can cause:

• Chronic diarrhea or constipation
• Low-fiber diet
• Obesity
• Pregnancy
• Sitting for too long on the toilet
• Straining during bowel movements

Anal Warts Causes

Anal warts are caused by the human papilloma virus (HPV), which is a sexually transmitted disease. Typically, they grow in and around the anus or the genitals.

Anal Fistulas Causes

An anal fistula is a tunnel from the inside of the anus to the skin around it.

A fistula is usually caused by an infection from a blocked or clogged gland inside the anus. The infected area will become an abscess, which is a pocket of swollen tissue and liquid. The abscess will push its way through the skin, creating a tunnel (the fistula) to the anus so the liquid can drain.

Common complaints of hemorrhoids, anal warts or anal fistulas can include itching, pain, discomfort or bleeding.

Hemorrhoids Symptoms

• Bloody streaks on stool
• Itching around the anus
• Pain or discomfort when sitting
• Lumps near the anus

Anal Warts Symptoms

• Itching
• Bleeding
• Discharge from the anus
• Lumps around the anus

Anal Fistulas Symptoms

• Pain, redness and swelling around the anus
• Pain during bowel movements or urinating
• Fever
• Foul-smelling discharge near the anus

If you suspect you have hemorrhoids, anal warts or an anal fistula, contact a gastroenterologist to start a treatment plan that’s right for you. Treatments can vary, but may include options like over-the-counter ointment and minimally invasive surgery:

Hemorrhoids Treatment

• High-fiber diet
• Topical ointments, available over-the-counter
• Warm baths
• Keeping anus clean
• Fragrance-free towelettes
• Over-the-counter pain relievers
• Surgery to treat blood clots
• Minimally invasive procedures for recurring hemorrhoids

Anal Warts Treatment

• Topical medication to freeze or burn warts
• Surgery to remove large warts or internal warts

Anal Fistulas Treatment

• Surgery

If you’re experiencing signs or symptoms of hemorrhoids, anal warts or anal fistulas, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) today.

Learn more about our doctors and care team who diagnose and treat hemorrhoids, anal warts and anal fistulas.

Hemorrhoids can literally be a pain.

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