Perianal Abscess vs. Hemorrhoids How to Tell the Difference
If you have new anal pain or bleeding, it can be hard to know what is happening. Two common conditions are perianal abscess and hemorrhoids. Understanding the differences helps you decide how urgently to seek care. At AZ Hemorrhoid & Anorectal Center in Chandler, San Tan Valley, and Scottsdale, our team provides prompt evaluation and personalized treatment so you can feel better with confidence. Meet our surgeons on the meet our experts page.
What is a perianal abscess
A perianal abscess is an infection that creates a pocket of pus near the anus. It often begins when a small anal gland becomes blocked. People usually notice constant throbbing pain that worsens with sitting, along with swelling, warmth, and sometimes fever or chills. An abscess rarely improves on its own and most cases need a brief procedure to drain the infection. Learn more about care for a perirectal abscess.
What is a hemorrhoid
Hemorrhoids are swollen veins in the lower rectum or around the anus. Internal hemorrhoids sit inside the rectum and often cause bright red bleeding with bowel movements. External hemorrhoids are under the skin around the anus and can itch or feel irritated. A sudden tender lump can happen when a clot forms in an external hemorrhoid. Many hemorrhoids improve with simple steps and comfortable office treatments. Read about internal hemorrhoids.
Key differences you can spot
Both conditions can cause discomfort, but they behave differently. Use these tips as a guide, keeping in mind that an in person exam is the only way to know for sure.
• Pain pattern: Constant deep pain that pulses and may come with fever points to an abscess. Hemorrhoid discomfort is often irritation or pressure with bowel movements or sitting.
• Drainage or swelling: Abscesses can drain pus or create a warm swollen area. Hemorrhoids may feel like soft tissue or a firm tender lump if a clot is present.
• Bleeding: Bright red blood on the toilet paper or in the bowl is more typical of internal hemorrhoids. Abscesses do not usually cause noticeable rectal bleeding.
• Urgency: Abscesses are infections that usually need timely drainage. Hemorrhoids are rarely emergencies and are often managed with lifestyle changes and office procedures.
When to seek care
Call for same-week evaluation if you have severe or worsening pain, fever, a new lump near the anus, or bleeding that keeps coming back. Early treatment can shorten recovery and lower the risk of complications.
• Severe continuous pain, especially with fever or chills
• Swelling or warmth next to the anus
• Recurrent bright red rectal bleeding
• A tender lump that appeared suddenly
During your visit, we perform a focused exam and, when helpful, a gentle scope or imaging. Abscesses are typically treated with a brief in-office or outpatient drainage. Hemorrhoid care ranges from fiber and topical relief to office procedures such as rubber band ligation. Every plan is tailored to your needs, and results vary from person to person. If you are unsure which condition you have, reach out through our contact us page for guidance.
Expert care you can trust
Aalok Sahai MD, is board-certified in general surgery and colorectal surgery. He has served the Chandler and San Tan Valley communities since 2007. Dr Sahai trained in general surgery at Washington University and Barnes-Jewish Hospital in St Louis and completed additional specialized colorectal training at Allegheny General Hospital in Pittsburgh. He has a strong interest in minimally invasive laparoscopic and robotic colorectal surgery using the advanced da Vinci Surgical System.
Paul Tender MD, is a board-certified colon and rectal surgeon with more than twenty-five years in practice and education. He completed general surgery training at Henry Ford Health System in Detroit and a colon and rectal surgery residency at Carle Foundation Hospital in Urbana. Dr Tender’s expertise includes office-based proctology, colon and rectal cancer, Crohn’s disease and ulcerative colitis, and diverticular disease. Get to know both physicians on the meet our experts page.
Next step toward relief
If you think you may have a perianal abscess or hemorrhoids, timely care can make a real difference in your comfort and recovery. Schedule a consultation with AZ Hemorrhoid & Anorectal Center in Chandler, San Tan Valley, or Scottsdale. Use our secure online form to request an appointment today by contacting us.
