Hemorrhoids can present with anal itching, bleeding during bowel movements (often bright red on the toilet paper or on the outside of the stool), pain, protrusion during bowel movements, sensitive lumps around the anus. So all your complaints can be explained by the hemorrhoid you have.
Since you have been diagnosed with internal haemorrhoids there can be two possibilities for the lump.
One is that the internal hemorrhoid which you have prolapses or protrudes from the anus during bowel movements. An internal hemorrhoid that prolapses, or extends outside the anus, can be quite painful. So if you feel the lump only on straining then its your internal hemorrhoid.
The other possibility is External hemorrhoid. This form of hemorrhoid is located around the anus and when inflamed feels like a hard lump. They are covered by skin, are very sensitive to touch, and can bleed, especially while straining during a hard bowel movement. They can be very painful especially on defecation. Pain is usually when hemorrhoid gets thrombosed (blood clot forms) which also produces swelling (lump) which you feel.
Treatment of hemorrhoids includes use of lidocaine
creams to help reduce pain.Stool softeners help reduce straining and constipation
. Avoid use of toilet tissue and donot scratch the area. Sitz baths for 15minutes (sitting in a tub of warm water )can help you to feel better.
Drink plenty of fluids, at least eight glasses per day along with high-fiber diet of fruits, vegetables, and whole grains.
If your hemorrhoids do not get better with home treatments, you may need a type of heat treatment to shrink the hemorrhoids. This is called infrared coagulation. This may help avoid surgery.
Surgery that may be done to treat hemorrhoids includes rubber band ligation
or surgical hemorrhoidectomy. These procedures are generally used for patients with severe pain
or bleeding who have not responded to other therapy.
Lump alone is not an indication of surgery.
Wishing you speedy recovery.