Are you experiencing pain during bowel movements, rectal bleeding, itching around the anus or discomfort while sitting? These symptoms can occur with several anorectal conditions, including piles, anal fissures and anal fistulas. Many people delay seeking advice because they feel embarrassed discussing symptoms affecting an intimate area.
Dr. V. Preethi Karthikeyan, MBBS, M.S. (General Surgery), FMAS, is a female surgeon in Chennai with a focus on laser procedures, laparoscopic surgery, proctology and breast surgery.
A proctologist evaluates conditions affecting the anus, rectum and surrounding tissues. Some cause discomfort over time, while others present with sudden pain, swelling or bleeding. A surgical consultation can help identify the cause and decide whether conservative treatment, medication, a procedure or surgery may be appropriate.
Swollen blood vessels in or around the anus that may cause bleeding, discomfort, itching or a lump.
A small tear in the lining of the anal canal that can cause sharp pain during or after passing stools.
An abnormal tunnel between the anal canal and the skin near the anus, sometimes with discharge or recurrent infection.
A collection of pus near the anus that may cause swelling, tenderness, pain and fever.
Affects the cleft between the buttocks near the tailbone and may cause pain, swelling or discharge.
Blood noticed during or after bowel movements that needs assessment to identify its cause.
Haemorrhoids with a blood clot, often causing a suddenly painful lump near the anus.
These conditions can have overlapping symptoms. A clinical assessment is important because not every case of anal pain or bleeding is caused by piles.
Consider a consultation if anorectal symptoms persist, recur or interfere with everyday activities. Early assessment can help identify the cause and reduce delays in appropriate care.
Seek prompt assessment if you have severe or worsening anal pain, a painful swelling with fever, pus with increasing redness, heavy or ongoing rectal bleeding, dizziness or black, tarry stools. Heavy bleeding or fainting needs emergency care.
Do not assume that rectal bleeding is caused by piles without being evaluated. Further investigations may be necessary depending on your age and health history.
They can all cause discomfort around the anus, but they are different conditions and may need different treatments.
| Condition | Common symptoms | General treatment approach |
|---|---|---|
| Piles (haemorrhoids) | Bleeding, itching, swelling or a lump | Dietary changes, bowel habit management, medication or a procedure when indicated |
| Anal fissure | Sharp pain during bowel movements, burning or bleeding | Stool-softening measures, prescribed medication and selected procedures or surgery if necessary |
| Anal fistula | Persistent discharge, a skin opening, recurrent swelling or infection | Surgical assessment; treatment may involve a procedure or surgery depending on the fistula |
Symptoms vary from person to person. A doctor can recommend the appropriate assessment and treatment based on the suspected condition and its severity.
A thrombosed external haemorrhoid occurs when a blood clot forms within an external haemorrhoid near the anal opening. It may appear as a firm, tender or bluish lump causing sudden, significant pain.
Not every thrombosed haemorrhoid requires surgery. Do not try to puncture or drain the lump yourself.
A pilonidal sinus is a small tract or cavity that commonly develops in the cleft between the buttocks near the tailbone. It may contain hair and debris and can become inflamed or infected.
A painful swelling with fever or spreading redness needs prompt assessment.
A collection of pus in the tissue around the anus. It may cause persistent or throbbing pain, swelling, tenderness, fever or discharge, sometimes without an obvious external opening.
An abscess may require drainage, and antibiotics alone are not always sufficient. Do not attempt to drain a swelling at home.
May appear as bright red blood on toilet paper, in the toilet bowl or mixed with stools. Piles and fissures are possible causes, but other conditions can also lead to bleeding.
Urgent care is needed for heavy or ongoing bleeding, dizziness, fainting, black stools or severe abdominal pain.
If you are visiting a female proctologist for the first time, knowing what to expect may help you feel more comfortable. The consultation is an opportunity to explain your symptoms privately and understand the next steps.
When symptoms began, whether they recur, pain or bleeding during bowel movements, and any constipation, discharge, swelling or fever.
Previous anorectal problems, past surgeries, existing conditions and the medicines you take.
Depending on your symptoms and consent, an examination may be recommended. Ask about the purpose of each step before proceeding.
The doctor explains the likely diagnosis, whether tests are needed and which treatment options may suit you.
Ask about preparation, aftercare, expected recovery, warning signs and follow-up appointments.
Treatment is based on the diagnosis, severity, examination findings, previous treatment and individual health needs.
May begin with dietary fibre, fluids, avoiding straining and treating constipation. Medication or an office-based procedure may follow; persistent haemorrhoids may require surgery.
Focuses on reducing constipation and straining, keeping stools soft and using prescribed medication. If a fissure does not heal, procedural or surgical options may be discussed.
Often needs surgeon assessment as it may not heal with medication alone. Treatment depends on the tract’s location, complexity and relationship to sphincter muscles.
A confirmed abscess may require surgical drainage, with additional treatment based on the infection. Prompt assessment helps prevent complications.
Not every anorectal condition requires surgery. Many patients begin with conservative treatment or medication.
| Condition | When a procedure or surgery may be considered |
|---|---|
| Piles | Persistent bleeding, prolapse, significant discomfort or non-responsive symptoms |
| Anal fissure | A chronic or non-healing fissure despite appropriate medical management |
| Anal fistula | A confirmed fistula that needs definitive treatment based on location and complexity |
| Perianal abscess | A collection of pus that requires surgical drainage |
| Pilonidal sinus | Recurrent disease, persistent discharge or an abscess requiring treatment |
| Thrombosed haemorrhoids | Selected cases with severe pain where a procedure may provide benefit |
No. Laser-based procedures may be considered for selected anorectal conditions, depending on diagnosis, severity and available clinical options.
A treatment recommendation should be based on clinical suitability rather than the technology alone.
Recovery varies with the condition, the treatment performed, and your overall health.
Your clinician may advise keeping stools soft, avoiding straining, following medication instructions and maintaining appropriate hygiene.
You may receive guidance on wound care, pain management, bathing, bowel habits, activity restrictions and follow-up appointments.
Contact your clinician promptly for increasing pain, fever, worsening swelling, spreading redness, pus or difficulty passing urine. Seek urgent care for heavy bleeding or fainting.
Discussing pain, bleeding, bowel movements or symptoms around the anus can feel uncomfortable. Many women prefer to speak with a female surgeon, particularly when anxious about discussing intimate symptoms or undergoing an examination.
AD 1, Water Canal Road, opposite Alliance Orchid Springs, near Varasakthi Nagar, Swaminathan Nagar, Puthagaram, Chennai – 600076.
No. 3, TS Krishna Nagar, Mogappair East, Chennai, Tamil Nadu – 600037.
101, Q Block, Anna Nagar 3rd Main Road, Anna Nagar East, Chennai, Tamil Nadu – 600040.
Do not ignore persistent anal pain, bleeding, swelling or recurring discomfort because of embarrassment. Early assessment can help identify the cause and clarify which treatment options may be appropriate.
Consultations at Kolathur, Mogappair or Anna Nagar · drpreethisurgeon.com
A female proctologist is a female medical practitioner or surgeon who evaluates and manages conditions affecting the anus and rectum. Patients may seek a female clinician if they feel more comfortable discussing intimate symptoms or undergoing an examination with a woman.
Consider a consultation for persistent or recurring anal pain, bleeding, swelling, itching, discharge, a lump near the anus or pain during bowel movements. Heavy bleeding, fainting, severe pain or fever with a painful swelling may require urgent assessment.
Some cases improve with dietary fibre, appropriate fluid intake, avoiding straining and clinician-recommended treatment. Other cases may need an office-based procedure or surgery, depending on the severity of symptoms.
Piles are swollen blood vessels in or around the anus. An anal fissure is a tear in the lining of the anal canal, while an anal fistula is an abnormal tunnel between the anal canal and nearby skin.
No. Piles are one possible cause, but fissures, inflammation and other bowel conditions can also cause bleeding. A clinician can assess the symptoms and decide whether further investigation is needed.
No. Suitability depends on the diagnosis, severity, anatomy and the procedure being considered. A surgeon should explain whether a laser-based procedure is appropriate.
A tract or cavity that commonly develops in the cleft between the buttocks near the tailbone. It can cause pain, swelling or discharge and may need medical or surgical treatment.
No. Some cases can be managed without surgery, while selected patients may benefit from a procedure when pain is severe or symptoms started suddenly.
Recovery depends on the condition and treatment performed. Conservative treatment, an office-based procedure and surgery have different recovery requirements.
You can enquire about an appointment with Dr. V. Preethi Karthikeyan at the Kolathur, Mogappair or Anna Nagar branches listed on this page.
