Small Hard Lumps in the Anus: Is It Hemorrhoids?

Hard mass in the anal canal?

Hello, doctor.
I have a question.
Recently, I discovered a hard lump about 3 centimeters inside my anus, roughly the size of a grain of rice (when palpated with my finger, it is at the depth of the first knuckle).
It is located at approximately the 11-12 o'clock position relative to the anus.
This small hard lump is not painful, not itchy, and there is no bleeding or discharge, nor any sensation of a foreign body.
Therefore, I went to a teaching hospital's colorectal surgery department for evaluation.
After a digital examination, the doctor indicated that it is hemorrhoids and prescribed oral anti-inflammatory medication and suppositories for me to use.

I would like to ask if this small lump is an early stage of hemorrhoids? Because this so-called small hard lump seems different from the general understanding of internal hemorrhoids (which are usually of a certain size, bleed, and are soft).
I am a bit concerned that this small lump could be something other than hemorrhoids, such as a tumor.
Is it possible that the very early stage of hemorrhoids can present as such a small lump? Additionally, I do not engage in anal intercourse, do not have constipation, chronic diarrhea, or prolonged standing or sitting, and my diet is relatively normal, with regular exercise.
I am quite puzzled as to how this hard lump could have developed.
I would like to hear your opinion, doctor.
Thank you.

0606, 30~39 year old female. Ask Date: 2018/06/06

Dr. Ke Fangxu reply Surgery

This small hard lump inside the anus is most likely a thrombosed hemorrhoid, which typically resolves on its own within 1-2 weeks.
Of course, conditions such as condyloma, low rectal cancer, and squamous cell carcinoma of the anal canal can also present as lumps in the anal area.
However, an experienced physician can often make a differential diagnosis based solely on the tactile sensation during a digital examination.
If further investigation is necessary, a biopsy in the operating room would be required.
However, I believe this may not be necessary, as thrombosed hemorrhoids are quite common and do not always have a specific triggering cause.
If you still have concerns, you may consider seeking a second opinion from another physician.

Reply Date: 2018/06/06

More Info

When it comes to small hard lumps in the anal area, the most common concern is indeed hemorrhoids, particularly if the lump is painless and does not exhibit any bleeding or discharge. Hemorrhoids can be classified into two main types: internal and external. Internal hemorrhoids are located inside the rectum and are usually not visible, while external hemorrhoids occur under the skin around the anus.
In your case, the lump you described, located approximately 3 centimeters inside the anus at the 11-12 o'clock position, could potentially be an internal hemorrhoid, especially since it is small, hard, and asymptomatic. It is not uncommon for early-stage hemorrhoids to present as small lumps without significant symptoms. The fact that you have no pain, bleeding, or other discomfort is a positive sign, as these symptoms often indicate more advanced issues.

However, it is essential to consider other possibilities. While hemorrhoids are the most likely cause, other conditions could present similarly, including anal warts, skin tags, or even more serious concerns like anal fissures or tumors. Given that you have already consulted a colorectal surgeon who diagnosed it as a hemorrhoid and prescribed medication, it is likely that they have ruled out more serious conditions based on their examination.
It is also worth noting that lifestyle factors, such as diet and exercise, can influence the development of hemorrhoids. Even if you do not experience constipation or prolonged sitting, factors like low fiber intake or straining during bowel movements can contribute to the formation of hemorrhoids.
If you are concerned about the lump or if it changes in size, shape, or symptoms, it would be prudent to follow up with your healthcare provider. They may recommend further evaluation, such as a colonoscopy, especially if you have any family history of colorectal issues or if you notice any new symptoms.
In summary, while your description aligns with early-stage hemorrhoids, it is always wise to remain vigilant and consult your healthcare provider if you have any concerns. Regular check-ups and open communication with your doctor can help ensure that any potential issues are addressed promptly.

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