There is pain usually on defecation that prevents proper sitting and causes immobility (commonly due to abscess, thrombosed haemorrhoids, or acute fissure-in-ano). Painless bleeding is commonly due to haemorrhoids but may be
due to colorectal carcinoma.
A patient with a perianal mass complains of feeling a mass (usually prolapsed haemorrhoids or anal tags) or has anal discharge that is associated with itching and is commonly associated with tumours, proctitis, and helminthic infestations.
Perineal discharge, on the other hand, is usually due to fistilae and is common in obese people.