Occur inside the rectum and are usually painless since this area has fewer pain-sensing nerves. They often cause bleeding during bowel movements and may prolapse (protrude) outside the anus in advanced stages.

Develop under the skin around the anus, in an area with many pain-sensing nerves. These can cause significant pain, itching, swelling, and discomfort, especially during sitting or bowel movements.

Internal piles that have stretched and protruded outside the anal opening. These may need to be pushed back manually or, in severe cases, occur permanently outside, often accompanied by pain, irritation, and mucus discharge.

A recent, superficial tear in the anal lining causing sharp pain and minor bleeding during bowel movements. Often heals with conservative treatment like diet changes and topical medication.

A long-standing fissure (lasting more than 6-8 weeks) with thickened edges, often accompanied by a skin tag (sentinel pile) and persistent pain. Usually requires medical or surgical intervention.

A fissure that returns after previous healing or treatment, often linked to ongoing constipation, poor bowel habits, or incomplete initial treatment. May need advanced surgical management.

Involves a limited portion of the sphincter muscle, located closer to the anal opening. Generally easier to treat with minimal risk to bowel control.

Passes through a larger portion of the sphincter muscle, often deeper and more intricate. Requires careful surgical planning to preserve continence. .

Fistulas that reappear after previous surgery or present with multiple tracts, often linked to underlying conditions (e.g., Crohn's disease) and needing specialized, advanced treatment.