Question: Please bear with me, this question is a bit long-winded.

I have been having trouble with external hemorrhoids for about 15 years now, off an on. No big deal. A little
Preparation-H and within a few days they typically "pop," bleed a bit and go away until the next round either a few months or a few years later, typically.

However, recently--over a month ago now--I developed what I assumed was another hemorrhoid, but it behaved differently. First, it was much larger than any hemorrhoid I've ever had. It showed up near the right side of my anus and was unusually large. It was at least the size of a large pea. Otherwise, however all the symptoms were the same: lots of burning pain, lots of itching, very difficult to sit and constant irritation. So I started my normal routine of Preparation-H about four times a day along with sitz baths.

Here's the issue: First, it took *A LONG* time to go away this time. About four weeks. And this time it never "popped" and bled, it just eventually disappeared. It seemed to come and go as well. Meaning that some times during the day, the skin felt almost "flat" like the hemorrhoid had gone away, but later it the day, the pea size bump returned. This happened over and over again. Also, when I went to "wipe" after using the toilet, it seemed to flatten out this hemorrhoid bump, but again, the bump would return later in the day. As I mentioned, it did finally eventually go away.

Here's the part that is really worrying me:

UNDERNEATH where the hemorrhoid was--basically right under and around my anus--I am feeling a lump. This lump has not gone away along with the hemorrhoid. It seems to move around. For example, if I am sitting on the toilet, I feel it mostly on my right side, but if I am standing in the shower or sitting in a bath tub, I can generally feel it around both sides of my anus. It's hard to judge the size, but I would say it feels like a large grape, maybe a bit larger. Sometimes this lump feels quite hard, and at other times it feels much softer. This lump feels almost like muscle tissue. I can press in on it and it does give a bit. It does seem to move around a bit. Also, it sometimes increases in size and sometimes it gets smaller. There are times I can literally feel it (I don't mean with my fingers--I can always feel it with my fingers--I mean just standing or sitting) when it seems to swell, and then when it seems to get smaller, I can't feel it. It is not causing any pain whatsoever. When I can feel it, I would say it feels like something stuck in my buttocks, or perhaps a feeling of "fullness," but it doesn't feel like the urge to use the toilet. It's a very strange feeling, but it does not hurt.

When I had the hemorrhoid, it literally felt like it was connected to this larger lump. The best way I know how to describe it, it felt like the portion of the hemorrhoid that is external--the pea sized lump that was hard and painful (the portion I was applying Preparation-H to)--was connected to this much larger lump like thing literally underneath the hemorrhoid.

I have recently lost 70 pounds. And let me stress: YES this weight loss was intentional. I have been on a diet and exercise program and have dropped from 230 to 160 and have lowered my body fat per cent from nearly 30% to about 15%. I have lost around 10 pounds a month, or so. I mention this because I have noticed normal things in my body that I didn't know I had since losing a whole bunch of fat that was of course covering those things in my body. So I am wondering if maybe this lump is normal, and I just have never felt it. I've been overweight since I was a child. Perhaps it is a normal part of my anus or rectum and I have never felt it before.

In any event, I am very worried about this lump and am trying to figure out what is might be. Should I be worried about a tumor? Anal cancer? Etc.?

Any advice would be greatly appreciated.

Thank you!

Kirk

Hello, Dr. Sejdini.

Thank you for your reply.

I have suspected that this lump may very well be an internal hemorrhoid as well, but let me ask:

Is it common for an internal hemorrhoid to last this long? I first felt this lump in mid-August (around the same time as I noticed the external hemorrhoid). So it's been close to two months now, and while the lump has at times decreased in size, it has also consistently increased in size, but in all this time it has not gone away fully.

Is that normal for an internal hemorrhoid? I haven't treated it with anything at all. I've only used Preparation-H externally for the external hemorrhoid that appeared at the same time.

Also, as I mentioned, this lump is pretty darn hard. It isn't as hard as say a marble or a rock would be, but it's pretty hard. At times it feels much firmer and harder and at other times it is softer and gives a bit when I press on it, but in general, it's pretty hard most of the time.

I don't know much about internal hemorrhoids. So far as I know, I've never had one, although I have been dealing with external hemorrhoids for more than 20 years or so.

Does this truly sound like an internal hemorrhoid to you? Yes I will go to my doctor, but in the mean time, how should I treat it? Should I use Preparation-H internally?

I look forward to your reply.

Thank you.

Kirk