Hard Lumps in the Anus: Are They Hemorrhoids?

Is it possible to feel a hard lump inside the anus with hemorrhoids?

I would like to ask the doctor if hemorrhoids can be very hard.
Are there hemorrhoids that do not bleed? I read online that hemorrhoids are soft and do not obstruct bowel movements.
I have felt a large hard lump about 1.2 finger joints inside my anus, closer to the abdominal side.
It does not hurt, and since my fingers are too short to determine the exact size, it is at least the size of a finger joint.
I believe this hard lump is causing my stool to become impacted and not fully evacuate, often resulting in small pieces or stools the size of a pinky finger being obstructed and unable to pass until the next bowel movement.
I underwent a colonoscopy, which only revealed the presence of hemorrhoids.
I know that there is a small piece of soft tissue that has protruded from my anus, which is a hemorrhoid.
However, could the hard lump I feel inside the anus also be a hemorrhoid? The internet mentions that thrombosed hemorrhoids can be harder, but I have never experienced any bleeding, and the lump does not hurt.
Could it be that the hard lump is located outside the colon, which is why it was not detected during the colonoscopy? Every time I feel that hard lump, I become very worried and anxious.
I kindly ask the doctor to clarify my doubts.
Thank you very much.

Xiao Chen, 40~49 year old female. Ask Date: 2024/07/11

Dr. Zhang Shuhao reply Surgery

If hemorrhoids develop a thrombosis, they may feel firmer than usual hemorrhoidal tissue, but they will not reach the hardness of a lump and will not obstruct bowel movements.
A colonoscopy can usually rule out tumor-related lesions.
It is recommended to first visit a colorectal clinic for an examination and inform the doctor about the location of the lump in order to receive an accurate diagnosis.

Reply Date: 2024/07/11

More Info

When it comes to understanding hard lumps in the anus, it is essential to consider various factors, including the nature of hemorrhoids and other potential conditions. Hemorrhoids are swollen blood vessels in the rectal area that can be either internal or external. Internal hemorrhoids are typically not painful and may not cause bleeding unless they become prolapsed or thrombosed. External hemorrhoids, on the other hand, can be painful and may appear as soft lumps around the anal opening.

In your case, you mentioned feeling a hard lump approximately 1.2 finger joints inside the anus, which does not cause pain and has not resulted in bleeding. This raises some important considerations. While hemorrhoids are generally soft and may not obstruct bowel movements, a hard lump could indicate a few different conditions.

1. Thrombosed Hemorrhoid: This occurs when a blood clot forms in an external hemorrhoid, leading to a hard lump that can be quite painful. However, since you mentioned that your lump is not painful and has not bled, this may be less likely.

2. Anal Fissure or Abscess: An anal fissure is a small tear in the lining of the anus that can cause pain and discomfort, while an abscess is a collection of pus that can form due to infection. Both conditions can lead to the formation of hard lumps, but they typically present with pain or discomfort.

3. Fecal Impaction: If you are experiencing difficulty with bowel movements and feel that small pieces of stool are getting stuck, it may indicate fecal impaction. This can lead to the formation of hard masses in the rectum, which may not be hemorrhoids.

4. Rectal Polyps or Tumors: While less common, hard lumps can also be indicative of rectal polyps or tumors. These growths can vary in size and consistency and may not always present with symptoms like bleeding or pain.

5. Other Conditions: Conditions such as anal warts (caused by human papillomavirus), skin tags, or even benign tumors can also present as hard lumps in the anal area.

Given that you have already undergone a colonoscopy, which did not reveal any significant issues beyond hemorrhoids, it is crucial to follow up with your healthcare provider. They may recommend further examination, possibly including a digital rectal exam or imaging studies, to assess the lump more thoroughly.

It is also important to note that while online resources can provide general information, they may not always apply to individual cases. Therefore, discussing your specific symptoms and concerns with a healthcare professional is vital for accurate diagnosis and treatment.

In summary, while hemorrhoids are typically soft and may not obstruct bowel movements, a hard lump in the anal area could be due to several factors, including thrombosed hemorrhoids, fecal impaction, or other conditions. Since you are experiencing symptoms that affect your bowel movements, it is advisable to seek further evaluation from a healthcare provider to ensure proper diagnosis and management.

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