Hard Lumps Near the Anus: Causes and Concerns

Perianal mass

Hello Doctor, I have recently noticed a small hard lump at the very front of my anus (closest to the genital area).
I'm not sure what it is.
I don't feel any pain when standing or sitting, as long as I don't touch it, but I do feel some discomfort when having a bowel movement, which feels like a possible tear in the anus, and there is a bit of pain.
A few days ago, I noticed a small amount of blood during a bowel movement, but I haven't seen any blood today.

1.
I would like to know if this could be a thrombosed hemorrhoid, or if it is simply a tear or something else, such as internal hemorrhoids, etc.?
2.
Is the tearing sensation related to this lump?
3.
If I don't touch it, will it heal on its own?

Tang Chai, 20~29 year old female. Ask Date: 2022/09/20

Dr. Zhang Shuhao reply Surgery

A sudden lump appearing at the anus is most commonly a thrombosed hemorrhoid, which is generally referred to as an exacerbation of hemorrhoids.
This condition arises when the blood vessels within the hemorrhoid become compressed, leading to subcutaneous bleeding and swelling, which may also be accompanied by a sharp pain.
It is advisable to take warm sitz baths, increase fluid intake and dietary fiber to prevent constipation, avoid prolonged sitting, and engage in more walking to enhance lower limb circulation.
Applying hemorrhoid ointment can also be beneficial.
Most cases show significant improvement within a week.

Reply Date: 2022/09/20

More Info

When it comes to hard lumps near the anus, there are several potential causes that can lead to discomfort, pain, or bleeding during bowel movements. Based on your description, it is important to consider a few possibilities, including thrombosed hemorrhoids, anal fissures, or other conditions such as anal warts or skin tags.

1. Thrombosed Hemorrhoids: One of the most common causes of hard lumps near the anus is a thrombosed hemorrhoid. This occurs when a blood clot forms in a hemorrhoid, leading to a painful, hard lump. These lumps are typically located externally, near the anal opening, and can cause significant discomfort, especially during bowel movements. The presence of blood during bowel movements can also be associated with this condition, as straining can exacerbate the situation.

2. Anal Fissures: Another possibility is an anal fissure, which is a small tear in the lining of the anus. This can occur due to passing hard stools or straining during bowel movements. The sensation of "breaking skin" that you mentioned could be related to this condition. Fissures can cause sharp pain during and after bowel movements, and they may also lead to bleeding.

3. Other Conditions: Other potential causes for a hard lump near the anus could include skin tags, which are benign growths that can occur after the resolution of hemorrhoids, or anal warts caused by the human papillomavirus (HPV). These conditions may not necessarily cause pain but can lead to discomfort depending on their size and location.

Regarding your specific questions:
1. Is this a thrombosed hemorrhoid or something else?: Given your symptoms, it is possible that you are dealing with a thrombosed hemorrhoid, especially if the lump is hard and painful during bowel movements. However, without a physical examination, it is difficult to provide a definitive diagnosis. It is advisable to consult a healthcare professional for an accurate assessment.

2. Is the "breaking skin" sensation related to the lump?: Yes, the sensation of breaking skin could be related to the presence of an anal fissure, especially if you are experiencing pain during bowel movements. The hard lump may also be contributing to discomfort, leading to straining and potential tearing of the anal lining.

3. Will it heal on its own?: In some cases, minor thrombosed hemorrhoids or anal fissures can heal on their own with conservative management, such as increasing fiber intake, staying hydrated, and using topical treatments to alleviate pain and promote healing. However, if the lump persists, becomes more painful, or if you experience significant bleeding, it is essential to seek medical attention. A healthcare provider can offer treatments such as rubber band ligation for hemorrhoids or topical medications for fissures.

In conclusion, while it is possible that your symptoms are related to a thrombosed hemorrhoid or an anal fissure, it is crucial to have a healthcare professional evaluate your condition for an accurate diagnosis and appropriate treatment. Self-care measures can help alleviate symptoms, but persistent or worsening symptoms warrant further investigation to rule out more serious conditions.

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