Brief Answer:
Povidone iodine locally, multivitamins, orally antibiotic

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/38 - raised- fleshy red bumps with white tops - itchy, burning, bleeding area around anus - painful when you go to bathroom - 3 weeks - married and faithful for 20 years - no anal sex - negative HPV - embarrassed to see your Doctor - taking Sits bath and witch XXXXXXX - wants to know what could this be and how to make it better ...

With the history your have provided, this looks to be peri-anal excoriation that has lead to the further stage of what you have at the moment.

Clear pictures sometimes helps to have on-the-spot diagnosis. I know it may be a difficult thing for you to do as is embarrassing to see your Doctor. You may please do it if you can and are willing.

I would advise you the following:
Continue Sitz bath, and to make the area dry after bath with a cotton cloth or with hair dryer and then apply solution povidone-iodine. This helps to make the area sterile and helps in killing the bacteria and helps in healing.
Take multivitamins as it acts as an anti-oxidant and helps early and better healing.
As per the history you have provided, this looks to be infected and a course of an antibiotic, metronidazole may help in control and better healing. Add probiotics too.
Mild laxative if there is history of constipation.
I can understand the embarrassment but a clinical examination by a Doctor/General Surgeon can help for a better understanding of the problem, get related investigations of the stool, blood and urine and you get a proper valid prescription for the antibiotics and so on.

With the history of monogamy and no anal sex, there is nothing much to worry about.

I hope this answer helps you, please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Was there any intestinal infection before this started?
Please give additional information as to how the problem started.

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