Small Bumps Near the Anus: Causes and Solutions - Gastroenterology and Hepatology

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Understanding small bumps near the anus can be concerning, especially following a history of hemorrhoids and anal fissures. Based on your description, it seems you are experiencing a few interconnected issues that may require careful consideration.

Firstly, the small bump you are feeling near the anus could be several things. Given your history of hemorrhoids, it is possible that this bump is a thrombosed hemorrhoid, which occurs when a hemorrhoid becomes swollen with blood and forms a painful lump. This can happen after straining during bowel movements, which is common in individuals with anal fissures or hemorrhoids. The fact that you have experienced bleeding during bowel movements and even when passing gas suggests that there may still be some irritation or damage to the anal area.

Another possibility is that the bump could be an anal abscess, which is a collection of pus that can form due to infection. This would typically be accompanied by more severe pain, swelling, and possibly fever. If the bump is hard and painful, it could also be a skin tag, which is a benign growth that can occur after the healing of hemorrhoids or fissures.

The increased secretion you mentioned could be a result of irritation in the anal area, which can occur with conditions like hemorrhoids or fissures. It is not uncommon for individuals with these conditions to experience changes in bowel habits and anal discharge.

Regarding your current treatment, it is good that you have started taking anti-inflammatory medication and using topical treatments like the one you mentioned. However, if you have not seen any improvement after a couple of weeks, it may be time to reassess your treatment plan. Here are some steps you can take:
1. Dietary Adjustments: Ensure you are consuming a high-fiber diet to help soften your stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also crucial.

2. Topical Treatments: Continue using topical treatments as directed. Over-the-counter creams that contain hydrocortisone can help reduce inflammation and discomfort.

3. Warm Sitz Baths: Taking warm sitz baths can help soothe the anal area and promote healing. Soaking for about 15-20 minutes several times a day can provide relief.

4. Avoid Straining: Try to avoid straining during bowel movements. If you feel the urge to go, do so promptly rather than waiting, as this can lead to harder stools.

5. Monitor Symptoms: Keep an eye on the bump. If it becomes increasingly painful, shows signs of infection (such as increased redness, swelling, or pus), or if you experience fever, you should seek medical attention promptly.

6. Consult a Healthcare Provider: Since you are currently in the U.S. and may not be able to return to Taiwan for a while, consider consulting a local healthcare provider. They can perform a physical examination and may recommend further treatments, such as prescription medications or even minor procedures if necessary.

In summary, while it is understandable to be concerned about the bump near your anus, there are several potential explanations, and many can be managed effectively with appropriate care. If symptoms persist or worsen, do not hesitate to seek medical advice. Your health and comfort are paramount, and addressing these issues sooner rather than later can lead to better outcomes.