Anal Masses: Symptoms, Causes, and Treatment Options

Anal mass

Hello, thank you for taking the time to respond.

Cleaning habits: During showers, I squat down and use a handheld showerhead to wash (sometimes I exert pressure to increase the water flow for a thorough clean).
When using the restroom, if the stool is not in a solid form, I tend to wipe several times.
I usually prefer to see little to no residue on toilet paper after wiping, typically around 3 to 4 wipes for soft stools.
Occurrence: On the evening of April 19, 2017, after waking up in the morning and using the restroom, I went to work, urinated, and during my lunch break while sitting on a chair, I felt no discomfort.
After work, I rode my motorcycle on various roads, both flat and rugged, and by the evening, after showering (I forgot to wash my buttocks during the shower and had no sensation), I had dinner (which I rushed through while standing, without any special sensation).
After dinner, while sitting on the sofa, I suddenly felt a slight pain in my anal area, which was quite unexpected since I had no sensation earlier that morning.
Location, appearance, texture, size, and pain: On the evening of April 19, I used a small mirror to examine the area.
The location was about one centimeter from the anal opening, at the 11 o'clock position, on the outer edge of the anal folds.
I noticed a small lump that appeared darker than the surrounding skin.
The lump was located slightly outward from the 11 o'clock position and blended in with the normal skin.

Appearance: On April 20 and 21, I checked again, and it was not very noticeable unless examined closely.
There was a slight protrusion on the right side of the anal fold, measuring approximately 0.2 to 1.1 centimeters, which did not appear inflamed and was similar in color to the surrounding skin.
There were no blisters or pimples, and if there was no pain, I would not have noticed anything unusual upon self-examination.
When I spread the skin around the area, the lump became more apparent, resembling a small bump, similar to a mosquito bite, but it required careful observation.
Texture, size, and pain: The texture did not feel like a soft blister; it was somewhat firm, resembling a small cucumber, possibly due to the underlying tissue.
The size was similar to that of a mosquito bite, but not as swollen (no obvious redness).
Pain: There is a slight sensation when standing or sitting, with more noticeable discomfort when leaning forward or backward while seated (possibly due to pressure).
When I contract my pelvic muscles or the anal sphincter, I feel a slight sensation, which is not painful but noticeable.
Pressing on the area causes mild discomfort, but it is tolerable, and I do not feel a strong urge to flinch or fear the sensation.
I am aware that pressing harder would cause more pain (though it is not advisable to press down excessively).
I do not experience itching, and there are no visible secretions.
The skin color does not appear unusual unless I specifically stretch the skin around the anus.
When I squat and look in the mirror, I can see a slight protrusion, which I only noticed because of the recent sensations.
Additionally, when I sneeze or hold my breath while attempting to relax the anal sphincter, I also feel a slight sensation in that area.
Sorry for the lengthy message.

USB, 20~29 year old female. Ask Date: 2017/04/21

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be a thrombosed external hemorrhoid.
A definitive diagnosis should be made by a physician.
If there is no swelling, pain, or fever, you can initially purchase hemorrhoid cream at a pharmacy for application.
However, if symptoms worsen or do not improve, it is important to consult a physician for further examination and treatment.

Reply Date: 2017/04/21

More Info

Understanding anal masses can be a complex topic, as they can arise from various causes and present with different symptoms. Based on the description provided, it seems that you are experiencing a small, protruding mass near the anal area, which has caused some discomfort but is not visibly inflamed or painful. Let's break down the potential causes, symptoms, and treatment options for anal masses.

Symptoms of Anal Masses
Anal masses can manifest in several ways, including:
1. Protrusion: As described, a small lump or bump near the anus can be felt or seen. This can vary in size and may resemble a mosquito bite or a small cyst.

2. Discomfort or Pain: While you mentioned that the pain is minimal and only noticeable when sitting or during bowel movements, discomfort is a common symptom associated with anal masses.

3. Bleeding: Although you did not report any bleeding, this can be a symptom of more serious conditions, such as hemorrhoids or anal fissures.

4. Itching or Irritation: You noted that there is no itching, which is a positive sign, as itching can indicate inflammation or infection.

5. Changes in Bowel Habits: Any changes in bowel habits, such as constipation or diarrhea, can also be related to anal masses.

Causes of Anal Masses
Several conditions can lead to the formation of anal masses, including:
1. Hemorrhoids: Swollen veins in the lower rectum or anus can create lumps that may be painful or itchy. They can be internal or external.

2. Anal Fissures: Small tears in the lining of the anus can lead to pain and the formation of small lumps.

3. Skin Tags: These are benign growths that can occur after an injury or irritation and may appear as small protrusions.

4. Abscesses: Infections can lead to the formation of pus-filled lumps that may require drainage.

5. Fistulas: An abnormal connection between the anal canal and the skin can create a lump and may be associated with pain and discharge.

6. Tumors: Although less common, both benign and malignant tumors can present as anal masses.

Treatment Options
The treatment for anal masses depends on the underlying cause:
1. Conservative Management: For conditions like hemorrhoids or skin tags, lifestyle changes such as increased fiber intake, hydration, and warm baths can help alleviate symptoms.

2. Medications: Over-the-counter topical treatments can relieve discomfort associated with hemorrhoids. If an infection is present, antibiotics may be necessary.

3. Surgical Intervention: If the mass is persistent, painful, or suspected to be a tumor, surgical removal may be required. This is particularly true for abscesses or fistulas that do not respond to conservative treatment.

4. Regular Monitoring: If the mass is benign and asymptomatic, regular monitoring may be sufficient, with follow-up appointments to ensure there are no changes.

When to Seek Medical Attention
It is crucial to consult a healthcare professional if you notice any of the following:
- Significant changes in the size or appearance of the mass.

- Persistent pain or discomfort that interferes with daily activities.

- Any signs of infection, such as increased redness, swelling, or discharge.

- Bleeding from the anus or changes in bowel habits.

In conclusion, while the symptoms you describe may not indicate a serious condition, it is essential to have a thorough evaluation by a healthcare provider. They can perform a physical examination and possibly recommend imaging studies or further tests to determine the exact nature of the anal mass. Early diagnosis and appropriate treatment can help prevent complications and improve your quality of life.

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