Which is more painful, external hemorrhoids or perianal abscesses?

Both external hemorrhoids and perianal abscesses may cause pain, but the pain caused by perianal abscesses is usually more severe and is often accompanied by systemic symptoms such as persistent distension, severe pain when touched, and fever. The pain of external hemorrhoids is mostly local tingling or a feeling of heaviness, which is usually aggravated by the formation of blood clots or external friction.

Perianal abscess is caused by the accumulation of pus due to anal gland infection, and severe pain is its common feature. This pain is often persistent and may become increasingly unbearable as the infection worsens. In severe cases, it can cause the inflammation to spread, and cause fever, fatigue and other general discomfort. External hemorrhoids are soft tissue bulges formed by the expansion of blood vessels at the end of the rectum. The pain is relatively mild, but obvious discomfort will be felt when thrombosed external hemorrhoids form or when bleeding is aggravated by friction stimulation. The two can also be distinguished by external manifestations: perianal abscesses are often accompanied by local redness, swelling, heat, pain and lumps, and may have pus exudation; the surface of external hemorrhoids is mostly purple-black blood clots or soft bulges, with no obvious signs of suppuration.

In terms of treatment, perianal abscesses require surgical drainage as soon as possible, which is the key to quickly relieve pain. The most common ones are incision and drainage and anal fistula prevention surgery, which are supplemented with antibiotics and cleaning care to prevent the spread of infection. External hemorrhoids are mainly treated according to the pathological type. Local excision can be considered for thrombosed external hemorrhoids, and inflammatory external hemorrhoids are suitable for warm water sitting baths with topical medications, such as compound carrageenan ointment or An Tai ointment; if it is only a mild normal external hemorrhoid, the main treatment is to improve diet and bowel habits to avoid further friction and stimulation. Daily care recommends a high-fiber, low-fat diet, drinking plenty of water to promote smooth bowel movements, and keeping the anus dry and clean to relieve local discomfort.

When facing severe pain from perianal abscess, do not squeeze it or abuse anti-inflammatory drugs by yourself. Go to the anorectal department of a regular hospital as soon as possible. For external hemorrhoids, it is recommended to focus on early prevention to minimize the risks of constipation and long-term sitting. If there is obvious pain or uncertain symptoms, a professional doctor needs to evaluate and choose the appropriate treatment method, intervene early, say goodbye to pain, and avoid further development and complications.