Bumps Between the Anus and Coccyx: Causes and Solutions

A mass located between the anus and the coccyx?

Hello Doctor: My symptoms appear as a protruding lump located between the anus and the coccyx (near the coccyx).
I have had an abnormal protrusion of the coccyx for several years, which varies in severity; sometimes it becomes swollen, and I feel discomfort when sitting.
Recently, I find it unsightly, as it is noticeably visible when standing, with a lump situated between the two buttocks.
This issue has gradually become a psychological burden for me, so I decided to consult the colorectal surgery department at Chang Gung Memorial Hospital, suspecting it might be hemorrhoids.
In the past, I experienced bleeding during bowel movements, but the doctor informed me that it was not hemorrhoids, but rather muscle inflammation caused by pressure on the coccyx, necessitating surgery to remove part of the coccyx and some nerves.
I wondered if it was that serious, so for the sake of a second opinion, I went to Mackay Memorial Hospital to see an orthopedic specialist, since it is a bone issue.
However, the consultation was quite frustrating; the doctor only listened to my description and immediately ordered an X-ray, telling me to return to review the results.
When I returned, the doctor said everything was fine, attributing my discomfort to being too thin and dismissed me.
I mentioned my discomfort, but the doctor prescribed a topical gel, similar to muscle relaxants, without even examining me.
The two doctors provided vastly different conclusions, leaving me feeling more confused.
Currently, I am applying herbal remedies to the protruding lump, hoping to resolve it, but I am uncertain whether I should seek a third opinion and which specialty to consult.
I hope you can provide some guidance.
Thank you.

Qiao Zhi, 20~29 year old female. Ask Date: 2001/05/27

Dr. Wang Qichao reply Surgery

There is a protruding mass between the anus and the coccyx.
Based on your description of the symptoms, it is likely a benign mass.
However, it is essential to have a doctor examine it in person for a definitive diagnosis.
You can schedule an appointment with a general surgery clinic.

Reply Date: 2001/05/27

More Info

Understanding the symptoms you are experiencing, particularly the bump located between the anus and the coccyx, is crucial for determining the appropriate course of action. Based on your description, it seems you have been dealing with this issue for some time, and it has become a source of discomfort and psychological burden for you.
The bump you are describing could potentially be several things, including but not limited to a pilonidal cyst, a skin tag, or a hemorrhoid. Given your history of tailbone protrusion and previous episodes of bleeding during bowel movements, it is understandable that you might suspect hemorrhoids. However, as you mentioned, your doctor has ruled out this possibility and suggested that the bump could be related to inflammation caused by pressure on the muscles from the tailbone.

Pilonidal cysts are common in the area you described and can occur when hair follicles become clogged with hair, dirt, and debris, leading to infection and the formation of a cyst. These cysts can become painful, especially when sitting or standing for long periods. If this is the case, surgical intervention may be necessary to remove the cyst and prevent recurrence.

On the other hand, if the bump is a result of muscle inflammation due to the abnormal protrusion of the coccyx, it may require a different approach. Surgical options, such as removing part of the coccyx, are sometimes recommended if conservative treatments fail to alleviate symptoms. However, surgery is typically considered a last resort after other treatments have been explored.

Your experience with two different doctors yielding vastly different opinions can be frustrating. It is essential to seek a second opinion, especially when dealing with potential surgical interventions. If you feel that the orthopedic doctor did not adequately address your concerns, it may be beneficial to consult a specialist in colorectal surgery or a general surgeon who has experience with conditions affecting the coccyx and surrounding areas.
In the meantime, applying topical treatments like muscle relaxants or anti-inflammatory gels, as prescribed, may provide some relief. However, it is essential to monitor the bump for any changes, such as increased size, redness, or discharge, which could indicate an infection that requires immediate medical attention.

In summary, while it is understandable to feel overwhelmed by the conflicting advice from different doctors, seeking a third opinion from a specialist in the appropriate field may provide clarity. It is crucial to communicate your symptoms thoroughly and express your concerns about the psychological impact this issue has on your daily life. Remember, you deserve a treatment plan that addresses both your physical discomfort and mental well-being.

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