Fissures: Fissures are small tears or cuts in the lining of the anus, often caused by passing hard stools. Fistulas: Fistulas are abnormal tunnels that form between the rectum or anus and the skin surrounding the anus. They can result from untreated abscesses or infections.
Pilonidal Sinuses: Pilonidal sinuses are small cysts or abscesses that develop in the crease between the buttocks. They are often caused by ingrown hairs or debris.
Piles (Hemorrhoids): Piles are swollen and inflamed veins in the rectum and anus. They can be internal (inside the rectum) or external (under the skin around the anus).

Fissures: Symptoms include pain during bowel movements, bleeding, itching, and a small lump near the anus.
Fistulas: Symptoms may include pain, swelling, discharge of pus or blood, and recurrent infections.
Pilonidal Sinuses: Symptoms include pain, swelling, redness, drainage of pus or blood, and sometimes fever.
Piles: Symptoms include rectal bleeding, itching, pain, swelling, and discomfort during bowel movements.

Diagnosis typically involves a physical examination, medical history review, and sometimes additional tests such as a digital rectal exam, anoscopy, sigmoidoscopy, or colonoscopy.