Hemorrhoids: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Diabetes mellitus (diabetes).
  • Hyperuricemia/gout

Skin and subcutaneous (L00-L99)

  • Anal eczema – symptom: itching
    • Chronic irritative eczema
    • Toxic exanthema – skin rash due to a toxic reaction (drug-toxic exanthema is the most common)
  • Erythrasma – redness of the skin caused by bacteria of the type Corynebacterium minutissimum, resembling that of mycosis; occurrence mainly in obese type 2 diabetics.
  • Infected pilonidal sinus (coccygeal fistula) – symptoms: burning and stabbing pain symptoms; continuous pain, regardless of bowel movements.
  • Psoriasis (psoriasis)

Infectious and parasitic diseases (A00-B99).

  • Diarrhea (diarrhea) of infectious origin.
  • Herpes analis (herpes in the area of the anus).
  • Condyloma (genital warts; human papillomavirus (HPV), serotypes 6, 11) – characterized by small lumps and itching.
  • Mycoses (fungal disease), unspecified.
  • Parasitoses – infestation of parasites, unspecified.
  • Syphilis (Lues) – sexually transmitted infectious disease.
  • Tuberculosis – infectious disease that affects mainly the lungs.

Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93).

  • Anal abscess – collection of pus in the region of the anus (with burning, stabbing, and dull pain symptoms; constant pain, varying in intensity depending on location).
  • Anal fissure (skin-mucous membrane tear in the area of the anus (anus)).
    • Acute anal fissure symptoms: accompanied by defecation-related anal pain: pain in the anal area/anorectal pain (severe, stabbing), especially during defecation
    • Chronic anal fissure; symptom: itching.
  • Anal fistula – connection between the anus and, for example, other parts of the intestine (with burning and stabbing pain symptoms; continuous pain, intensity fluctuating) → clarification of Crohn’s disease required; in about 40% of cases, this is the first symptom of the disease.
  • Anal cryptitis – inflammation of the anus (with burning and stabbing pain symptoms; continuous pain, increased after defecation).
  • Anal marisques – non-retractable flaccid skin folds (marisques) at the anus.
  • Anal prolapse – prolapse of the anus, or the anal mucosa in front of the sphincter.
  • Anal vein thrombosis (AVT; synonyms: Anal thrombosis, perianal thrombosis, perianal vein thrombosis, perianal thrombosis) – occlusion of a vein in the region of the anus; acute onset of perianal pain with stabbing pain symptomatology; occurrence after stronger pressing act, lifting heavy loads, etc.; the inspection (observation) shows one or more prallelastic nodules, which are discolored blue-livid
  • Hypertrophic anal papilla (synonyms: anal polyp, anal fibroma).
  • Incarcerated hemorrhoidal prolapse – pinched protrusion of a hemorrhoid (with burning and stabbing pain symptoms; continuous pain, after stronger pressing act).
  • Incarcerated rectal prolapse – pinched protrusion of the rectum.
  • Proctalgia fugax (anorectal pain syndrome; anal spasm / anal spasm) – short-term cramp-like pain conditions in the anal and rectal area.
  • Proctitis – inflammation of the rectum (dull pain symptomatology; increased bowel movements, continuous pain, before bowel movements increasingly, afterwards relief).
  • Rectal prolapse (rectal prolapse)
  • Sphinctersclerosis – rigidity of the sphincter muscle.

Musculoskeletal system and connective tissue (M00-M99).

  • Coccygodynia – pain in the coccyx – (with sharp stabbing and sharp pain symptoms; intermittent).

Neoplasms – tumor diseases (C00-D48).

  • Anal carcinoma (anal cancer) – symptoms: slowly increasing nodes, no pain and no bleeding.
  • Leukemia (blood cancer)
  • Rectal cancer (rectal cancer)

Psyche – nervous system (F00-F99; G00-G99)

  • Anal neurosis

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Hyperhidrosis (excessive sweating).
  • Icterus (jaundice)

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99)

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Allergies, unspecified

Medications

  • Permanent medication with glucocorticoids (local/local) – drugs against inflammation and allergic reactions.