Soft Swelling Near Anus During Bowel Movements: Causes and Solutions

Soft lumps on both sides of the anus during straining?

Recently, I have been experiencing a feeling of constipation when using the restroom.
When I looked in the mirror, I noticed that the areas around my anus appeared swollen and felt soft to the touch; they retract when I relax.
There is no pain, but occasionally I notice a small amount of blood when wiping.
A few days ago, I had severe diarrhea.

A-Ruan, 20~29 year old female. Ask Date: 2023/02/02

Dr. Ke Fangxu reply Surgery

This situation is likely due to hemorrhoidal swelling, which can be caused not only by constipation but also by diarrhea.
It is recommended to avoid both constipation and diarrhea by increasing your intake of dietary fiber and shortening the time spent on the toilet.
This can help prevent hemorrhoidal swelling.
Additionally, taking a warm sitz bath after bowel movements can also be beneficial.

Reply Date: 2023/02/02

More Info

The symptoms you are experiencing, particularly the soft swelling near the anus during bowel movements, could be indicative of several conditions, most commonly hemorrhoids or anal fissures. Given your description, it’s important to understand the potential causes and appropriate solutions.

Possible Causes
1. Hemorrhoids: These are swollen veins in the lower rectum and anus, similar to varicose veins. They can be internal or external. The soft swelling you feel could be an external hemorrhoid, especially if it appears during bowel movements. Hemorrhoids can cause discomfort, itching, and sometimes bleeding, especially when straining during bowel movements.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during bowel movements and may cause bleeding. The sensation of swelling could be due to the surrounding tissue reacting to the fissure.

3. Abscess or Infection: In some cases, a soft swelling could indicate an abscess, which is a collection of pus that can form near the anus due to infection. This would typically be accompanied by pain and possibly fever.

4. Skin Tags: Sometimes, after the resolution of hemorrhoids or fissures, skin tags can form, which are benign and may feel soft and movable.

5. Inflammatory Conditions: Conditions like inflammatory bowel disease (IBD) can also lead to swelling and discomfort in the anal area.

Solutions and Recommendations
1. Dietary Changes: To alleviate constipation, which can exacerbate hemorrhoids and fissures, increase your fiber intake. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, ensure you are drinking plenty of water to help soften stools.

2. Over-the-Counter Treatments: There are various topical treatments available for hemorrhoids, such as creams or ointments that contain hydrocortisone or witch hazel. These can help reduce inflammation and discomfort.

3. Warm Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help soothe the area and promote healing.

4. Avoid Straining: When using the bathroom, try to avoid straining, as this can worsen hemorrhoids and fissures. If you are experiencing constipation, consider using a stool softener or a mild laxative after consulting with a healthcare provider.

5. Consult a Healthcare Provider: Since you mentioned occasional bleeding, it is crucial to consult with a healthcare professional. They can perform a physical examination to determine the exact cause of your symptoms and recommend appropriate treatment. If hemorrhoids or fissures are diagnosed, they may suggest procedures for more severe cases.

6. Monitor Symptoms: Keep track of your symptoms, including any changes in bowel habits, the frequency of bleeding, and any pain. This information will be valuable for your healthcare provider.

When to Seek Immediate Care
If you experience severe pain, significant bleeding, or signs of infection (such as fever or increased swelling), seek medical attention promptly. These could be signs of a more serious condition that requires immediate treatment.

In summary, while the soft swelling near your anus during bowel movements could be due to hemorrhoids or anal fissures, it is essential to consult with a healthcare provider for an accurate diagnosis and tailored treatment plan. Making dietary changes and practicing good bowel habits can significantly improve your symptoms and overall bowel health.

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