Hard Lump Near Anus After Infection: Should I Seek Surgery?

There is swelling and pain near the anus, and after taking anti-inflammatory medication, a hard lump has developed?

Hello Doctor, a few days ago I sent this inquiry https://adoctor.tw/article/182559 [email protected].
The next day, I realized it didn't seem like my period because my sanitary pad was empty.
I feel like it might be pus or blood from the injured area? The pain also seemed to lessen the next day.
In any case, I went to a nearby clinic's surgery department, and the doctor quickly examined me and said I had a bacterial infection and inflammation.
He applied a povidone-iodine solution and bandaged it up, asking if I wanted an anti-inflammatory injection, which I agreed to.
He also prescribed me medication (the names on the prescription were SeaPRO, FUITEN F.C., and AMOXICILLIN) and told me to return for a follow-up in two days.
My question is, the area that originally hurt is indeed less painful now; I can sit and walk without pain.
However, when I touch the previously swollen and painful area, I notice there is a hard lump, and pressing it firmly causes a slight pain.
What should I do? Do I need to go to a major hospital for surgery?

Xiao Qianyi, 10~19 year old female. Ask Date: 2022/06/08

Dr. Zhang Shuhao reply Surgery

Based on the description, it seems that there is some discharge on the surface of the abscess.
You can start taking the antibiotics and anti-inflammatory medications prescribed by your doctor.
Once the lump softens, you can proceed with incision and drainage.
In some cases, it may completely resolve without the need for surgery.
General surgery or colorectal surgery clinics can assess and manage the situation.
Therefore, take your medications as scheduled and return for your follow-up appointment as advised.

Reply Date: 2022/06/08

More Info

It sounds like you are experiencing a complex situation with a hard lump near your anus following a bacterial infection. Based on your description, it seems that you have already sought medical attention and received initial treatment, which is a good first step. However, the presence of a hard lump that is still causing discomfort warrants further evaluation.

Understanding the Situation
1. Bacterial Infection and Inflammation: The hard lump you are feeling could be a result of the inflammation from the bacterial infection. In some cases, infections can lead to the formation of an abscess, which is a collection of pus that can feel firm or hard to the touch. This can happen if the body is trying to contain the infection.

2. Symptoms and Signs: The fact that the pain has decreased is a positive sign, indicating that the initial treatment may be effective. However, the persistence of a hard lump and any tenderness upon palpation can suggest that the infection may not be fully resolved or that an abscess has formed.

3. Treatment Options: The medications you have been prescribed, including Amoxicillin, are typically effective against many bacterial infections. However, if there is an abscess, antibiotics alone may not be sufficient. Surgical intervention may be necessary to drain the abscess and promote healing.

When to Seek Further Medical Attention
- Persistent Symptoms: If the hard lump does not decrease in size or if you experience increasing pain, fever, or any other concerning symptoms, it is crucial to return to your healthcare provider or seek a second opinion, preferably from a specialist in colorectal surgery or a general surgeon.

- Follow-Up Appointment: Since you have a follow-up appointment scheduled, it is essential to discuss the hard lump with your doctor. They may perform a physical examination and possibly imaging studies (like an ultrasound) to assess the nature of the lump.

- Surgical Consideration: If the lump is determined to be an abscess or if there is a suspicion of other complications, your doctor may recommend surgical intervention. Surgery can help drain the abscess and remove any infected tissue, which can lead to a more rapid recovery.

Conclusion
In summary, while the initial treatment seems to be helping with the pain, the presence of a hard lump that is still tender is a sign that further evaluation is needed. It is advisable to keep your follow-up appointment and communicate all your symptoms clearly to your doctor. If necessary, do not hesitate to seek a second opinion or ask for a referral to a specialist. Early intervention can prevent complications and promote a better outcome. Remember, your health is paramount, and it’s always better to err on the side of caution when it comes to potential infections and surgical needs.

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