Perineal and Anal Masses: Causes and Treatment Options

There is a mass in the perineal and anal area?

Hello doctor, I have been walking more recently and have experienced pain in the perineal area.
There is a slight stinging sensation when I touch it, which I initially thought was due to friction.
Recently, while showering, I noticed that the area near the anus is somewhat painful, and after 1-2 days, I discovered a noticeable lump that is painful when pressed.
Today marks the third day since I noticed the pain, and when sitting down, I feel a foreign sensation in the anal area.
The lump causes pain when pressed, and my bowel movements are normal without blood.
Upon palpation, I can feel a lump located on the right side of the perineum near the anus, and photos clearly show significant swelling.
I would like to ask the doctor what this could be, which specialty I should consult, and how to prevent it from worsening.
Thank you.

Mr. Huang, 30~39 year old female. Ask Date: 2020/01/15

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please visit the colorectal surgery department.

Reply Date: 2020/01/15

More Info

Understanding perineal and anal masses is crucial for identifying potential health issues and determining appropriate treatment options. Based on your description of symptoms, including pain, a palpable mass near the anal area, and discomfort while sitting, there are several possible causes for your condition.

Possible Causes
1. Hemorrhoids: These are swollen veins in the lower rectum and anus that can cause pain, discomfort, and sometimes bleeding. They can be internal or external, with external hemorrhoids being more likely to cause pain and a palpable mass.

2. Anal Abscess: This is a collection of pus that forms near the anus due to infection. It can cause significant pain, swelling, and a feeling of pressure. An abscess may require drainage and antibiotics.

3. Fistula-in-Ano: This is an abnormal connection between the anal canal and the skin near the anus, often resulting from a previous abscess. It can cause persistent pain and discharge.

4. Skin Tags: These are benign growths that can occur around the anal area, often following irritation or inflammation. They are usually painless but can become irritated.

5. Perianal Warts: Caused by the human papillomavirus (HPV), these can appear as small growths around the anal area and may cause discomfort.

6. Other Conditions: Less commonly, conditions such as anal cancer or inflammatory bowel disease (IBD) can present with similar symptoms.

Recommended Actions
Given your symptoms, it is advisable to consult a healthcare professional. The most appropriate specialist for your situation would be a colorectal surgeon or a gastroenterologist. They can perform a thorough examination, which may include a physical exam and possibly imaging studies, to determine the exact nature of the mass and recommend treatment.

Prevention and Management
To prevent worsening of your condition, consider the following:
- Avoid Straining During Bowel Movements: Straining can exacerbate hemorrhoids and other anal conditions. Ensure a high-fiber diet and adequate hydration to maintain regular bowel movements.

- Maintain Good Hygiene: Keeping the anal area clean can help prevent infections. Use gentle cleansing methods and avoid harsh soaps.

- Warm Sitz Baths: Soaking in warm water can help relieve pain and discomfort associated with anal conditions.

- Avoid Prolonged Sitting: If sitting exacerbates your pain, try to limit the time spent sitting and use cushions for added comfort.

- Monitor Symptoms: Keep track of any changes in symptoms, such as increased pain, bleeding, or changes in bowel habits, and report these to your healthcare provider.

Conclusion
In summary, the symptoms you describe could be indicative of several conditions, ranging from benign to more serious issues. It is essential to seek medical evaluation to determine the cause of your symptoms and receive appropriate treatment. Early intervention can prevent complications and improve your quality of life.

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