Diagnosis	History	Physical examination
Abscess	Gradual onset of pain	Tender fluctuant mass
Cancer	Pain, bleeding, changes in bowel movements, weight loss	Ulcerating, indurated lesion
Condyloma	Possible bleeding; anal intercourse	Verrucous lesions
Fissure	Tearing pain with bowel movements	Visible tender fissure
Fistula	Soiling, itching	Visible opening of fistula
Inflammatory bowel disease	Bloody diarrhea, abdominal pain, family history	Possible fistula; colitis on anoscopy
Polyps	Painless bleeding	Polyps on endoscopy
Proctalgia fugax	Painful rectum, no bleeding	Normal examination; diagnosis of exclusion
Proctitis	Painful rectum, bleeding	Tenderness on digital rectal examination
Rectal prolapse	Mass with Valsalva maneuver	Prolapse of rectal mucosa
Skin tags	History of hemorrhoids, no bleeding	Tags covered with normal skin