Rectal Hard Lumps: Possible Causes and Concerns

Issue of a hard mass in the anus?

Hello, Doctor.
A few days ago while showering, I discovered a hard lump inside my anus (about one finger joint deep) on the side closer to the front of my body.
It is slightly larger than a red bean, with a rough surface.
It doesn't resemble a mosquito bite that has swollen under the skin; rather, it seems like a flat growth on the outside.
There is no bleeding or pus, and when I touch it, the sensation is between feeling and not feeling; it is almost painless.
The most I feel is a slight sensation similar to a minor abrasion from wiping with toilet paper after diarrhea, especially after sitting for a long time or during anal contraction.
I have already made an appointment with a colorectal surgeon, but since I am a bit anxious, I would like to ask what conditions are more likely to be the cause.
Thank you, Doctor.

KEMBA, 30~39 year old female. Ask Date: 2021/10/02

Dr. Ke Fangxu reply Surgery

The exact issue can only be determined through examination; most likely it is thrombosed hemorrhoids, but anal polyps and malignant tumors are also possible, although the latter is less likely.

Reply Date: 2021/10/02

More Info

When it comes to the discovery of a hard lump in the rectal area, there are several potential causes that could explain this condition. It is important to approach this situation with caution and seek medical advice, as you have already done by scheduling an appointment with a colorectal surgeon. Here are some possible explanations for the hard lump you are experiencing:
1. Hemorrhoids: One of the most common causes of lumps in the rectal area is hemorrhoids, which are swollen veins in the rectum or anus. They can be internal or external and may present as hard lumps. While they can be painful, some people experience minimal discomfort. The lump you described could be a thrombosed hemorrhoid, which occurs when a blood clot forms in an external hemorrhoid, leading to a hard, painful lump.

2. Anal Fissures: An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools. While fissures typically cause sharp pain during bowel movements, they can also lead to the formation of a lump or tag of tissue at the site of the tear.

3. Skin Tags: These are benign growths of skin that can develop around the anal area, often as a result of previous irritation or inflammation. They are usually painless and can feel like small lumps.

4. Abscesses: An anal abscess is a collection of pus that can occur due to infection. While you mentioned that there is no bleeding or pus, it is still a possibility to consider, especially if the lump becomes painful or swollen.

5. Fistulas: An anal fistula is an abnormal connection between the anal canal and the skin. It often develops after an abscess and can present as a lump near the anus. Fistulas can cause discomfort and may require surgical intervention.

6. Tumors: Although less common, both benign and malignant tumors can develop in the anal or rectal area. These may present as hard lumps and can be associated with other symptoms such as changes in bowel habits or bleeding.

Given that you have already scheduled an appointment with a colorectal surgeon, it is essential to follow through with that consultation. The surgeon will likely perform a physical examination and may recommend further diagnostic tests, such as an ultrasound or colonoscopy, to determine the exact nature of the lump.

In the meantime, here are some general recommendations to help manage your symptoms:
- Avoid Straining: If you are experiencing any discomfort during bowel movements, try to avoid straining, as this can exacerbate the condition.

- Warm Baths: Taking warm baths can help soothe the area and may provide some relief from discomfort.

- Dietary Adjustments: Ensure that you are consuming a high-fiber diet to prevent constipation and reduce the strain during bowel movements. Staying hydrated is also crucial.

- Pain Management: Over-the-counter pain relievers may help alleviate any discomfort you are experiencing.

It’s understandable to feel anxious about this situation, but remember that many conditions affecting the anal and rectal area are treatable. Your healthcare provider will be able to provide you with a proper diagnosis and treatment plan tailored to your specific needs.

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