a Hard Lump Near the Anus: Is It Hemorrhoids?

There is a firm, round lump in the anal area?

A few days ago (about 3 days ago), after using the restroom, I noticed a very noticeable round hard lump while wiping, approximately no larger than 0.5 centimeters.
When I looked in the mirror, it was the same color as the anus.
I have a history of hemorrhoids, but this lump is hard, while the others are softer.
So I would like to ask the doctor, is this a hemorrhoid? It can be pushed back into the anus, and when it first appeared, it was a bit painful, but I haven't felt much discomfort in the following days.
Does this require a doctor's visit for surgery?

Ou, 20~29 year old female. Ask Date: 2021/12/08

Dr. Zhang Shuhao reply Surgery

Most protrusions are thrombosed hemorrhoids, caused by bleeding from the subcutaneous blood vessels of the hemorrhoids.
During an episode, it is advisable to take warm sitz baths, supplemented with oral anti-inflammatory medications and hemorrhoid ointments.
The blood clots will gradually be reabsorbed.
It is important to stay well-hydrated and avoid constipation during this period.
If the pain is severe, one may seek medical attention for local thrombectomy.
Wishing you a speedy recovery.

Reply Date: 2021/12/08

More Info

When it comes to a hard lump near the anus, especially if you have a history of hemorrhoids, it is understandable to be concerned about what it could be. Based on your description, it sounds like you may be experiencing a condition related to hemorrhoids, but there are several possibilities to consider.

Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified as either internal or external. Internal hemorrhoids are located inside the rectum and are usually not visible. External hemorrhoids, on the other hand, are located under the skin around the anus and can be felt as lumps. They can become painful if a blood clot forms inside them, leading to a condition known as a thrombosed hemorrhoid. This could explain the hard lump you are feeling, especially if it is painful when it first appears.

The fact that the lump is about 0.5 cm and has a similar color to the surrounding skin is also indicative. Thrombosed hemorrhoids can be quite painful initially but may become less painful over time as the clot resolves. The lump may feel hard due to the clot and the surrounding inflammation. If it is indeed a thrombosed hemorrhoid, it may not require surgical intervention unless it becomes very painful or does not resolve on its own.

However, it is crucial to differentiate between hemorrhoids and other potential conditions that could present similarly. Other possibilities include anal warts, skin tags, or even more serious conditions like anal fissures or tumors. Given that you have a history of hemorrhoids, it is possible that this lump is related, but it is essential to have a healthcare professional evaluate it to rule out other conditions.

Here are some recommendations for managing your symptoms and determining the next steps:
1. Observation: If the lump is not causing significant pain and is not changing in size, you may choose to monitor it for a few days. Many thrombosed hemorrhoids will resolve on their own.

2. Warm Sitz Baths: Taking warm baths can help soothe the area and reduce discomfort. This can also promote blood flow to the area, which may help with healing.

3. Over-the-Counter Pain Relief: If you are experiencing pain, over-the-counter medications such as acetaminophen or ibuprofen can help alleviate discomfort.

4. Dietary Changes: Ensure you are consuming a high-fiber diet and staying hydrated to prevent constipation, which can exacerbate hemorrhoid symptoms.

5. Consult a Healthcare Professional: If the lump persists, increases in size, becomes increasingly painful, or if you notice any bleeding, it is essential to see a doctor. A healthcare provider can perform a physical examination and may recommend treatments such as rubber band ligation, sclerotherapy, or surgical removal if necessary.

In conclusion, while it is possible that the hard lump you are feeling is a thrombosed hemorrhoid, it is essential to have it evaluated by a healthcare professional to ensure proper diagnosis and treatment. Early intervention can prevent complications and help manage symptoms effectively.

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