
What Causes Painful Lump Near Anus Causing Discomfort?

Im having a kind of lump or dimple around the anus, and would like to know your opinion on the condition.
I recently showed it to one homeopathic doctor and she diagnosed it as pilondial cyst.
However, I would like to have a second opinion and hence reaching out to you.
Would appreciate if you could take a look at the attached picture and let me know what yiu think.
Few things to help you diagnose
- This is 2 inch away from the anus and is on the back of anus crack
- Initially I had lot of paid during the fisrt week, but the pain has reduced during last 10 days.
- Discomfort while sitting
- No constipation
- Size of the pimple has remained consistent.
- Bleeding happened only once during 20 days, but have seen white colored pus coming out of the lump sometime.
Looking forward for your input.
Best regards,
XXXXXX
Pilonidal Sinus.
Detailed Answer:
Hi XXXXXXX
Thanks for your query, elucidate history and clear pictures.
All the history an picture is suggestive of a condition called a Pilonidal Sinus. You have a predisposing factor- the hair around the area.
The sinus means a tract which is opened on the outside.
The picture you have provided shows a typical position, the sprouting granulation and history is typical of this.
I would advise in such a patient the following:
Get an antibiotic cover.
Consult a general Surgeon.
Surgery planned as soon as possible for the chance for a cure. In this case a simple opening of the whole tract at this stage has very good results.
I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications if you feel there is a gap of communication.


Would you rule out Abscess and Fistula looking at the lump and symptoms?
Also, yesterday I noticed a white pus coming through the pimple and today it drained blood. Let me know if you forsee any trouble.
Finally, can this be cured without surgery? If so any details would be appreciated. Currently I'm on Homeopathy medication.
Thanks again
XXXXXXX
Usually curable only with Surgery.
Detailed Answer:
Thanks XXXXXXX for your feedback and query.
The sprouting seen in the picture is very classical of the Pilonodal Sinus. And in fact this is an abscess only. The name of the abscess in this position is given as Pilonidal sinus because in some cases hair is / are found after exploration - hence the name Pilonidal...(nest of hair). Also called as cyst or a fistula...but this is basically a sinus.
You have got this problem for the first time as per your history.
A simple abscess would have healed up by this time- more than 20 days now.
The bleeding is an indication that there are 'granulation tissues' inside (they bleed easily on rubbing as this area is always under movements).
And the pus indicates that there is an active infection. By this time the granulation tissue, the debris and the hair if present act as the foreign body not allowing the cure. It may close temporarily to give false sense if healing and recurs after sometime.
It is very rare for this to heal /cure without proper surgery.
I can understand why would you be taking the Homeopathy Medicines, you may be afraid of surgery or you want to avoid surgery.
At least a simple curratage and laying open the whole tract may help you to get a cure. Earlier the better as the fibrosis is minimal and healing is very good in the initial stages.
So in my XXXXXXX opinion get a Consultation of a General Surgeon, discuss with him and get operated. You may please continue your Homeopathy medicines. You can go for a combined approach.
Prithvi- you are young, just 29, get a cure fast. Do not be late, the tract may go on enlarging, and the late surgery will be a larger wound and the chances of recurrence increase with the late surgery.
I hope this answer helps you to get to the early and proper decision-making so that the cure is possible.

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