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

Small hard lump near the anus?

Hello Doctor, about a month ago, I noticed a small bump on the left side of my anus, approximately two centimeters in size, resembling an early-stage pimple.
It is not painful, so I haven't taken any special action, but I've been keeping an eye on it.
Recently, over the past week, it seems to have become slightly more prominent, similar to an acne bump, but it still doesn't hurt.
Squeezing it does not cause any rupture, pus, or bleeding.
My overall health includes a long-standing issue with irregular bowel movements, sometimes experiencing constipation and occasional diarrhea (I have also frequently used enema solutions in the past), and I often have poor sleep quality, but there are no other significant issues.
I would like to ask what this bump could possibly be.
Could it be related to an anal fistula?

KaKa, 20~29 year old female. Ask Date: 2015/08/17

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, there is a hard lump near the anus, which may be due to subcutaneous inflammation or a fistula.
Please consult a colorectal surgeon.
Sincerely, Dr.
Chen Chi-Feng, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/08/17

More Info

When it comes to small bumps near the anus, there are several potential causes that one should consider. Based on your description, the bump you have noticed is about two centimeters from the anus, resembles an early-stage pimple, and is not painful. It is important to approach this situation with caution, as various conditions can present similarly.

1. Hemorrhoids: One of the most common causes of bumps around the anal area is hemorrhoids, which are swollen blood vessels that can occur either internally or externally. External hemorrhoids can appear as small lumps and may not always be painful, especially if they are not thrombosed (clotted). They can be associated with constipation and straining during bowel movements, which aligns with your history of irregular bowel habits.

2. Anal Abscess or Fistula: An anal abscess is a collection of pus that can form near the anus, often due to an infection. If the bump were to become painful, swollen, or show signs of drainage, it could indicate an abscess. An anal fistula is a small tunnel that can develop between the anal canal and the skin, often following an abscess. While your bump does not currently exhibit these characteristics, it is something to keep in mind.

3. Skin Tags: These are benign growths that can occur around the anal area, often as a result of previous irritation or trauma. They are usually painless and can vary in size. Skin tags are generally harmless but can be removed if they become bothersome.

4. Pilonidal Cyst: Though more common in the sacrococcygeal area, a pilonidal cyst can sometimes present near the anus. These cysts can become infected and may require surgical intervention if they do.

5. Warts or Other Lesions: Genital warts caused by the human papillomavirus (HPV) can also appear in the anal area. These may feel like small bumps and can vary in size and appearance. Other skin conditions, such as folliculitis (inflammation of hair follicles), could also be a possibility.

Given your history of constipation and occasional diarrhea, it is important to maintain regular bowel habits to prevent further complications. Straining during bowel movements can exacerbate conditions like hemorrhoids or lead to the development of new bumps.

Recommendations:
- Observation: Since the bump is not painful and does not show signs of infection (such as redness, warmth, or drainage), you may choose to monitor it for changes.

- Consultation: It is advisable to consult a healthcare professional, preferably a gastroenterologist or a proctologist, for a thorough examination. They can provide a definitive diagnosis and rule out any serious conditions.

- Lifestyle Modifications: Focus on maintaining a healthy diet rich in fiber to promote regular bowel movements and prevent constipation. Staying hydrated is also crucial.

- Avoid Irritation: Be gentle when cleaning the area and avoid any harsh soaps or irritants that could exacerbate the condition.

In summary, while the bump you are experiencing could be benign, it is essential to have it evaluated by a healthcare provider to ensure proper diagnosis and management. Early intervention can prevent potential complications and provide peace of mind.

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