Perianal Swelling: When to Seek Medical Attention

There is a swelling near the anus?

Hello, I have an anal fissure and have been taking Laxative for over a year with little improvement.
Recently, I noticed a pattern: I take one packet of Laxative every afternoon, and for about half a month, my bowel movements have been normal without blood.
However, yesterday I discovered a sudden lump next to my anus.
Currently, there is no discharge, and it doesn't hurt normally, but it is painful when pressed.
Since I am working across the strait, I am considering whether I should immediately return to Taiwan for a doctor's examination or if I should observe the situation for a while.

R, 30~39 year old female. Ask Date: 2017/10/16

Dr. Xu Kaixi reply Surgery

Based on your description, this lump is more likely to be a thrombosed external hemorrhoid.
It is recommended to seek treatment at a local surgical outpatient clinic, as it usually improves with medication and conservative therapy.

Reply Date: 2017/10/16

More Info

When it comes to perianal swelling, especially in the context of a history of anal fissures, it is essential to approach the situation with caution. Your experience of having a fissure and ongoing treatment with medications like Laxative (likely referring to a laxative or stool softener) indicates that you are already managing a chronic condition. The sudden appearance of swelling near the anus can be concerning, and understanding when to seek medical attention is crucial.

Firstly, it’s important to assess the characteristics of the swelling. If the swelling is firm, painful upon pressure, and there are no signs of infection (such as redness, warmth, or discharge), it may be a localized reaction to your existing condition or a minor issue like a thrombosed hemorrhoid. However, if the swelling is accompanied by any of the following symptoms, it is advisable to seek medical attention promptly:
1. Increased Pain: If the pain worsens or becomes severe, this could indicate an infection or other complications.

2. Fever: A fever may suggest an underlying infection that requires immediate treatment.

3. Changes in Bowel Habits: If you experience changes such as increased bleeding, diarrhea, or constipation, these could signal a more serious issue.

4. Discharge: Any pus or unusual discharge from the area could indicate an abscess or infection.

5. Persistent Symptoms: If the swelling does not resolve within a few days or continues to grow, it is essential to consult a healthcare provider.

Given your history of anal fissures, it is also possible that the swelling could be related to a perianal abscess, which can occur when an anal fissure becomes infected. This condition may require drainage and antibiotics, so it’s important not to ignore it.

In your case, since you are currently working across the strait and considering whether to return to your doctor in Taiwan, it may be wise to err on the side of caution. If the swelling persists or worsens, or if you develop any of the concerning symptoms mentioned above, it would be prudent to seek medical attention as soon as possible.
In the meantime, you can manage your symptoms by:
- Maintaining Good Hygiene: Keep the area clean and dry to prevent further irritation or infection.

- Warm Sitz Baths: Soaking in warm water can help alleviate discomfort and promote healing.

- Pain Management: Over-the-counter pain relievers may help manage any discomfort, but consult your healthcare provider before taking any new medications.

Ultimately, while it may be tempting to wait and see, your health and comfort should be the priority. If you have any doubts or concerns, reaching out to a healthcare professional for advice is always a good idea. They can provide guidance tailored to your specific situation and medical history.

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