What else could it be?

Among lay people it is quite common to attribute pain and discomfort in the anal region to piles. However, there are many other conditions which may simultaneously be present or cause similar symptoms. Diagnosis should therefore always be left to a physician.
The good news is that despite their unpleasant symptoms, hemorrhoidal disease is a benign condition. However, what looks like a hemorrhoid problem may also be indicative of another more dangerous illness. The list of anorectal diseases with similar symptoms includes for example:
If you have anal bleeding or discomfort in the anal region, you should see your doctor. He can easily find out what is behind your symptoms or if necessary make further investigations.