Finding a lump in the anus naturally causes concern. While any unusual growth should be evaluated by a healthcare professional, most lumps in this region are caused by common, non-life-threatening conditions. These masses often relate to irritation, inflammation, or strained blood vessels. This article provides general information about the possible nature of a small anal lump, but it is not a substitute for a medical diagnosis.
Identifying Common Causes
The most frequent cause of a lump around the anal opening is hemorrhoids, which are swollen veins in the anal canal and rectum. External hemorrhoids form beneath the skin outside the anus and are typically felt as a soft, skin-colored bulge. They can cause itching, discomfort, and may bleed slightly, especially after a bowel movement.
A more acute and painful type is a thrombosed external hemorrhoid, which occurs when a blood clot forms within the swollen vein. This condition results in a hard, firm lump that is intensely painful and may appear dark, such as bluish-purple, due to the trapped blood. The severe pain usually peaks within the first 48 hours, though the swelling can take several weeks to resolve.
Another common type of lump is an anal skin tag, which is excess tissue remaining after a previous irritation has healed. These soft, flesh-colored protrusions are composed only of skin tissue, not swollen blood vessels, and are generally painless. Skin tags often form after a hemorrhoid or another inflammatory condition has subsided and the stretched skin does not retract completely. Unlike active hemorrhoids, skin tags do not typically bleed unless severely irritated by friction.
Recognizing More Serious Conditions
While most lumps are benign, some indicate an infection, a chronic condition, or, rarely, malignancy. A perianal abscess is a localized pocket of pus resulting from an infection of the small glands lining the anal canal. This condition presents as a tender, swollen, and warm lump, often accompanied by severe, constant pain that worsens with sitting or movement. An abscess requires prompt medical drainage to relieve pressure and prevent complications.
An anal fistula is a small, abnormal tunnel connecting the infected anal gland to an opening on the skin outside the anus. This condition frequently results from a previous, undrained, or recurring abscess. A fistula may present as a firm, recurring lump or a small hole near the anus that continuously discharges fluid, pus, or occasionally blood.
Anal warts (condylomata acuminata) are caused by the human papillomavirus (HPV) and are highly contagious. These growths begin as small, soft, flesh-colored bumps that can multiply and cluster, sometimes developing a rough, cauliflower-like texture. While often painless, anal warts can cause itching, bleeding, or a noticeable discharge.
In rare instances, a lump may be a sign of anal cancer, which is typically a firm, fixed mass that grows over time. Unlike the soft, movable nature of a hemorrhoid, a cancerous lesion feels hard and may be associated with persistent symptoms. These symptoms include unexplained bleeding, chronic pain, or a change in bowel habits. Anal cancer growths are often irregular in shape and require a biopsy for definitive diagnosis.
Determining the Next Steps for Diagnosis
Any new, persistent, or changing lump in the anal area warrants an examination by a healthcare provider, such as a primary care physician or a specialist like a proctologist or gastroenterologist. Certain “red flag” symptoms require urgent medical attention to rule out a severe infection or other serious disease. These warning signs include a mass that is growing rapidly, a lump accompanied by a high fever or chills, or uncontrollable, significant rectal bleeding.
It is important to seek professional care if you experience severe or unrelenting pain, a noticeable change in the caliber or frequency of your stool, or symptoms that do not improve within a week of at-home care. Diagnosis is typically confirmed through a physical examination, which includes a visual inspection of the area. The doctor may also perform a digital rectal exam, gently inserting a lubricated, gloved finger into the rectum to feel for masses, tenderness, or abnormalities inside the anal canal. In some cases, a small lighted tube called an anoscope may be used for a clearer view of the lower rectum. A professional evaluation is the only way to accurately confirm the cause and establish an appropriate treatment plan.