“I have a pea-sized lump on my anus. I can’t bring myself to tell my doctor, and I just want it to go away. Could it be a hemorrhoid? What should I do?”
Don’t be embarrassed, be safe! There are many reasons for lumps around the anus, and most are fairly harmless. Common problems include hemorrhoids, skin tags, abscesses, cysts and warts. More than 50% of adults will have hemorrhoids (swollen, enlarged blood vessels) at some time in their lives. There are two types—internal (inside the lower rectum) and external (on the outer edge of the anus). A blood clot may develop in an external hemorrhoid, stretching out the skin and creating a painful, firm lump that feels like a marble or pea. It can cause bleeding and itching. Internal hemorrhoids may prolapse outside the rectum. Skin tags are a painless flap of tissue, sometimes occurring with a tear in the anal canal (fissure) caused by hard bowel movements. Perianal abscesses are pus-filled infections around the anus. They are usually very painful and develop over several days. They may drain spontaneously but otherwise should be drained promptly by a doctor. Sebaceous cysts are lumps that form when the sebaceous glands around hair follicles get plugged up. They may also become infected. Anal warts are growths due to infection with the human papillomavirus (HPV) and are usually spread by sexual contact. They should be removed. Anal cancer is fairly rare but has some of the same symptoms (bleeding, pain, itching and/or an anal growth) as benign conditions. In most cases, an anal lump will go away by itself in two or three weeks. To relieve discomfort, sit in a tub of warm water. If the lump is painful or doesn’t go away or if anal bleeding continues for more than a few days, see a colorectal surgeon. He/she can evaluate the lump and remove it if needed.
