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What Causes Hard Lump On The Outside Of Rectal Opening?
Question: Dear Doctor,
Please give us your best possible take on the following condition:
A hard lump 0,5cm-1cm right under (on the outside) of the rectal opening. Please see attached file. The lump feels like cartilage and its possible to wiggle it. The lump does not have any specific color, but if you stretch the surface, the lump looks a bit white.
Lump does not feel warm nor does it itch or sting.
There is no pain when touching the lump and not even if you try to pinch it. However there is pain under the lump, like something under the lump hurts, maybe because the lump is pressing against something under it. There is pain and aching in the lump area when passing stool. After that, the pain and aching is gone for a while and then comes back. Does not seem to be a problem with the skin itself but rather whats under the skin.
Patient has been using rectal cream containing hydrocortisone and lidocaine for 10 days and the lump has not gotten any smaller nor bigger. The cream takes away some of the pain, probably because it contains lidocaine. Patiens has previously been passing a little bit of bloody stools (clear red) but this seems to have improved by the use of the cream mentioned earlier.
Please give us your best possible take on the following condition:
A hard lump 0,5cm-1cm right under (on the outside) of the rectal opening. Please see attached file. The lump feels like cartilage and its possible to wiggle it. The lump does not have any specific color, but if you stretch the surface, the lump looks a bit white.
Lump does not feel warm nor does it itch or sting.
There is no pain when touching the lump and not even if you try to pinch it. However there is pain under the lump, like something under the lump hurts, maybe because the lump is pressing against something under it. There is pain and aching in the lump area when passing stool. After that, the pain and aching is gone for a while and then comes back. Does not seem to be a problem with the skin itself but rather whats under the skin.
Patient has been using rectal cream containing hydrocortisone and lidocaine for 10 days and the lump has not gotten any smaller nor bigger. The cream takes away some of the pain, probably because it contains lidocaine. Patiens has previously been passing a little bit of bloody stools (clear red) but this seems to have improved by the use of the cream mentioned earlier.
Brief Answer:
Detailed below
Detailed Answer:
Hello.
Thank you for the query.
This lump is most likely a hemorrhoid or sentinel node which is a symptom of anal fissure. Both lumps can look the same, both can give pain while passing the stool and blood in the stool. Also both conditions are caused by constipation.
Hemorrhoid can not be healed without surgery, however medicines can decrease it and help with the pain. Fissure can be treated with medicines.
Please try such treatment:
start probiotic intake and increase fiber rich products
do not push hard on stool
wash your anus after every stool
have sitz baths with Oak Bark
start hemmorhoids suppositories
If this want help in a week, consult proctologist.
Hope this will help. Feel free to ask furthet questions.
Regards
Detailed below
Detailed Answer:
Hello.
Thank you for the query.
This lump is most likely a hemorrhoid or sentinel node which is a symptom of anal fissure. Both lumps can look the same, both can give pain while passing the stool and blood in the stool. Also both conditions are caused by constipation.
Hemorrhoid can not be healed without surgery, however medicines can decrease it and help with the pain. Fissure can be treated with medicines.
Please try such treatment:
start probiotic intake and increase fiber rich products
do not push hard on stool
wash your anus after every stool
have sitz baths with Oak Bark
start hemmorhoids suppositories
If this want help in a week, consult proctologist.
Hope this will help. Feel free to ask furthet questions.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for your valuable response.
I would like to add some more details regarding the lump. The lump does not seem to be swollen, but rather the lump is hard and more like a node. And like I wrote earlier it is possible to wiggle it.
Question1: Are hemmorhoids or sentinel nodes suppose to be like this?
I’ve attached some new pictures. Could you please have a look at them as well?
Moreover I would like to add that the past few weeks, patient mostly has loose stool, with the exception that a few weeks ago, the patient was constipated.
Question2: Do you see any reason for suspecting cancer?
Question3: If you don’t suspect cancer, could you please give some reasons why you don’t think its cancer?
Best regards
Worried patient
Thank you for your valuable response.
I would like to add some more details regarding the lump. The lump does not seem to be swollen, but rather the lump is hard and more like a node. And like I wrote earlier it is possible to wiggle it.
Question1: Are hemmorhoids or sentinel nodes suppose to be like this?
I’ve attached some new pictures. Could you please have a look at them as well?
Moreover I would like to add that the past few weeks, patient mostly has loose stool, with the exception that a few weeks ago, the patient was constipated.
Question2: Do you see any reason for suspecting cancer?
Question3: If you don’t suspect cancer, could you please give some reasons why you don’t think its cancer?
Best regards
Worried patient
Brief Answer:
.
Detailed Answer:
1. Yes, hemorrhoids and sentinel nodes can be like in your description. Please note that some hemorrhoids can contain blood clot and can be really hard.
On the new pictures it really looks like a hemmorhoid. In this area abscess should be considered, but it clearly looks like a hemmorhoid. No doubt in that.
Loose stools can also cause hemmorhoid appearance outside the rectum especially those which give high pressure in the rectum.
2. At the age of 28 colon cancer or rectal cancer is hardly possible. Colon cancer is strongly associated with age. Most of the cases appears over the age of 50. Before this age only hereditary cancer can give symptoms. It would be possible if there were any cases of colon cancer in young age in your family.
3. I have given the main reason why its not a cancer above. Moreover rectal cancer gives hard, easily bleeding, uneven tumor instead of firm and rounded lump. This simply does not look like a cancer at all.
So please follow mentioned in previous answer steps and the lump should get smaller. If not consult proctologist and consider its removal.
Regards.
.
Detailed Answer:
1. Yes, hemorrhoids and sentinel nodes can be like in your description. Please note that some hemorrhoids can contain blood clot and can be really hard.
On the new pictures it really looks like a hemmorhoid. In this area abscess should be considered, but it clearly looks like a hemmorhoid. No doubt in that.
Loose stools can also cause hemmorhoid appearance outside the rectum especially those which give high pressure in the rectum.
2. At the age of 28 colon cancer or rectal cancer is hardly possible. Colon cancer is strongly associated with age. Most of the cases appears over the age of 50. Before this age only hereditary cancer can give symptoms. It would be possible if there were any cases of colon cancer in young age in your family.
3. I have given the main reason why its not a cancer above. Moreover rectal cancer gives hard, easily bleeding, uneven tumor instead of firm and rounded lump. This simply does not look like a cancer at all.
So please follow mentioned in previous answer steps and the lump should get smaller. If not consult proctologist and consider its removal.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for you answers.
Its good to hear that you do not think it is cancer. However, I would still like to ask you if you know if there is any blood test to take in order to be on the safe side and what type of blood test? Or a faeces sample?
So you have mentioned 3 possible conditions that it could be, hemmorhoid, sentinel node or abscess.
1. I assume this would be an external hemmorhoid, what is the best possible non surgical treatment for this? Patient has already been on suppositories without any luck and is not passing hard stool.
2. What is the best non surgical treatment you would recommend if this is a sentinel nodes?
3. What is the best non surgical treatment you would recommend if this is a abscess?
I believe you previously mentioned that medicines could decrease the lump but I don’t think you mentioned what kind if medicine?
Best regards
Thank you for you answers.
Its good to hear that you do not think it is cancer. However, I would still like to ask you if you know if there is any blood test to take in order to be on the safe side and what type of blood test? Or a faeces sample?
So you have mentioned 3 possible conditions that it could be, hemmorhoid, sentinel node or abscess.
1. I assume this would be an external hemmorhoid, what is the best possible non surgical treatment for this? Patient has already been on suppositories without any luck and is not passing hard stool.
2. What is the best non surgical treatment you would recommend if this is a sentinel nodes?
3. What is the best non surgical treatment you would recommend if this is a abscess?
I believe you previously mentioned that medicines could decrease the lump but I don’t think you mentioned what kind if medicine?
Best regards
Brief Answer:
.
Detailed Answer:
There is no blood or stool test which would rule colon cancer in 100%. That is why colon cancer can be only ruled out with colonoscopy.
I am 99% sure that this is hemorrhoid. I am 100% sure this is not an abscess. And this also does not look like a sentinel node (please note that sentinel node is not a disease, its a symptom of rectal fissure).
Answering your questions:
1. There is no non-surgical permanent solution for hemorrhoids. Like I have mentioned before, medicines can only help with symptoms and make it less visible. But no medicine can make it disappear.
2. Sentinel node, or better rectal fissure can be treated with stool softening diet, OTC available suppositories for rectal problems (in every country this medicines are under different names so I am unable to give an exact brand name). If the fissure lasts longer than 3 weeks, it becomes chronic fissure and can be treated only with surgical removal.
3. Abscess can be treated with surgical incision ONLY.
Regards.
.
Detailed Answer:
There is no blood or stool test which would rule colon cancer in 100%. That is why colon cancer can be only ruled out with colonoscopy.
I am 99% sure that this is hemorrhoid. I am 100% sure this is not an abscess. And this also does not look like a sentinel node (please note that sentinel node is not a disease, its a symptom of rectal fissure).
Answering your questions:
1. There is no non-surgical permanent solution for hemorrhoids. Like I have mentioned before, medicines can only help with symptoms and make it less visible. But no medicine can make it disappear.
2. Sentinel node, or better rectal fissure can be treated with stool softening diet, OTC available suppositories for rectal problems (in every country this medicines are under different names so I am unable to give an exact brand name). If the fissure lasts longer than 3 weeks, it becomes chronic fissure and can be treated only with surgical removal.
3. Abscess can be treated with surgical incision ONLY.
Regards.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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