External Anal Masses: When to Seek Medical Advice

Perianal mass

Hello Doctor: In the past, I would use a bidet to clean myself after using the toilet, and then wipe dry with toilet paper, which was never an issue.
However, recently I have been unable to use the bidet for cleaning and have been directly wiping with toilet paper and washing with my hands.
Recently, after straining during a bowel movement, I noticed that the toilet paper was completely stained with bright red blood.
In the following days, I have had difficulty wiping clean after using the toilet, and there has been some blood mixed in.
Today, while wiping, I felt one or two lumps around the anal area, which do not hurt when touched.
My daily life is normal and I do not feel any discomfort.
I would like to know if I should consult a professional doctor as soon as possible.
I usually have bowel movements 1 to 2 times a day at regular times, and the appearance of the stool is normal.
Thank you for your assistance!

R, 20~29 year old female. Ask Date: 2021/09/25

Dr. Ke Fangxu reply Surgery

Although the probability of developing colorectal cancer at the age of 22 is not zero, it is generally very low.
Based on your description, it seems more like hemorrhoidal bleeding.
I recommend starting with a light diet and maintaining a good lifestyle.
Spicy, irritating, and greasy foods should be avoided.
Increasing your intake of dietary fiber can also be beneficial.
If the symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.

Reply Date: 2021/09/25

More Info

When it comes to external anal masses, it is essential to understand the potential causes and when to seek medical advice. Based on your description, it appears that you have experienced some concerning symptoms, including the presence of blood on toilet paper after bowel movements and the discovery of lumps near the anal area. While you mention that you are not currently experiencing pain and that your bowel habits are regular, the presence of blood and lumps warrants further evaluation.

Understanding External Anal Masses
External anal masses can arise from various conditions, including hemorrhoids, anal fissures, skin tags, or more serious issues such as abscesses or tumors. Here’s a brief overview of these conditions:
1. Hemorrhoids: These are swollen blood vessels in the rectal area that can cause bleeding, especially during bowel movements. They can be internal or external, with external hemorrhoids often causing discomfort and swelling.

2. Anal Fissures: These are small tears in the lining of the anus, often resulting from passing hard stools. They can cause pain and bleeding during bowel movements.

3. Skin Tags: These are benign growths that can occur around the anal area, often as a result of previous hemorrhoids or irritation.

4. Abscesses: These are collections of pus that can occur due to infection and may present as painful lumps.

5. Tumors: Although less common, both benign and malignant tumors can present as anal masses and may be associated with bleeding.

When to Seek Medical Advice
Given your symptoms, it is advisable to seek medical attention for the following reasons:
- Presence of Blood: Any instance of bright red blood in the stool or on toilet paper should be evaluated by a healthcare professional. While it may be due to hemorrhoids or fissures, it is essential to rule out more serious conditions.

- Lumps or Masses: The discovery of lumps near the anal area, even if they are not painful, should be assessed. A healthcare provider can perform a physical examination and may recommend further imaging or procedures if necessary.

- Changes in Bowel Habits: While you report regular bowel movements, any changes in frequency, consistency, or the presence of discomfort should be discussed with a doctor.

- Persistent Symptoms: If the bleeding continues or worsens, or if you develop new symptoms such as pain, itching, or changes in bowel habits, it is crucial to seek medical advice promptly.

Conclusion
In summary, while your current symptoms may not seem alarming, the presence of blood and lumps near the anal area is a sign that you should consult a healthcare professional. They can provide a thorough evaluation, potentially including a physical examination and diagnostic tests, to determine the underlying cause of your symptoms. Early diagnosis and treatment can help prevent complications and ensure your health and well-being.
It is always better to err on the side of caution when it comes to changes in your body, especially in sensitive areas such as the anal region. Please consider scheduling an appointment with a gastroenterologist or a colorectal surgeon for a comprehensive assessment.

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