Painful enlarged veins in the rectal area are?

The correct answer is: Hemorrhoids.

Hemorrhoids are swollen and enlarged veins in the rectum and anus. They are thought to be caused by the straining that occurs during bowel movements, childbirth, or other activities that increase the pressure in the veins of the rectum. Hemorrhoids can be painful, especially when they are thrombosed, which means that a blood clot has formed inside the vein. They can also cause bleeding, itching, and difficulty with bowel movements.