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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes a pea sized hard bump in the anal region?

Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1944 Questions

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Posted on Wed, 16 May 2018 in Digestion and Bowels
Question: Hi Doctor,

Last couple of days I noticed a hard solid hemorrhoid formed in the anus area. Its a size of pea and there is no pain fortunately. I am not sure what it is and I am not sure if it is a hemorrhoid.

It is solid and when I touch it, it is like a pea and no bleeding. I am doing hot bath daily but I don't see it shrinking.

Is there anything to worry ?
doctor
Answered by Dr. Ramesh Kumar 20 minutes later
Brief Answer:
Go for proctoscopic examination by general surgeon.

Detailed Answer:
Hello Dear,
Thanks for choosing HealthcareMagic for your query.

I've gone through your details and I appreciate your concerns.

Most likely you are having hemorrhoids, which are inflamed veins in the anus or rectum. Please attach a photo with follow up.

I would suggest you plan a visit to a general surgeon and get a proctoscopy and digital examination of rectum done to rule out hemorrhoids as a cause of the problem.

If hemorrhoids are diagnosed then Three types of managements are there
1)Conservative
2)Non invasive
3)Invasive surgical

Initially we start with conservative management for at least 3 months-
Suggestion for conservative management are-

Start taking Syp. Lactulose 10-15ml once daily before going to bed. It is one of the most frequently used laxatives, tolerated very well by patients in long terms with minimal side effects. Using laxative would prevent straining while defecating.

-Secondly, start using Ruticool a combination containing contains Calcium Dobesilate, Hydrocortisone, Lignocaine, and Zinc.) locally over the prolapsed hemorrhoids.

Thirdly, request your gastroenterologist to prescribe you with oral Calcium Dobesilate-Doxium therapy for 3 months. Initially twice daily for 21 days followed by once daily for 10 weeks. Trials have shown that 3-month therapy can cause shrinkage of Hemorrhoids in almost 60% cases.It was demonstrated that calcium dobesilate decreased capillary permeability, inhibited platelet aggregation and improved blood viscosity; thus resulting in reduction of tissue edema.

Add Metamucil/Fybrogel to your regimen. It's a natural laxative containing husk. It absorbs water from the intestine and swells up making passage of stool easy and add bulk to stool.Take it 2 tsf twice daily with half cup of XXXXXXX warm milk.


If not relieved by it in 3 months then Noninvasive methods are tried like-

1)Sclerotherapy: This is currently recommended as a treatment option for first- and second-degree hemorrhoids. The rationale of injecting chemical agents is to create a fixation of mucosa to the underlying muscle by fibrosis.

2)Rubber band ligation: Rubber band ligation (RBL) is a simple, quick, and effective means of treating first- and second-degree hemorrhoids and selected patients with third-degree hemorrhoids. Ligation of the hemorrhoidal tissue with a rubber band causes ischemic necrosis and scarring, leading to fixation of the connective tissue to the rectal wall.

3)Cryotherapy: Cryotherapy ablates the hemorrhoidal tissue with a freezing cryoprobe. It has been claimed to cause less pain because sensory nerve endings are destroyed at very low temperature.

In case if this is not successful then we have invasive surgical procedures like-

1)Hemorrhoidectomy: Excisional hemorrhoidectomy is the most effective treatment for hemorrhoids with the lowest rate of recurrence compared to other modalities.Success rate is more then 90%.

2)Stapled hemorrhoidopexy-A circular stapling device is used to excise a ring of redundant rectal mucosa proximal to hemorrhoids and resuspend the hemorrhoids back within the anal canal. Apart from lifting the prolapsing hemorrhoids, blood supply to hemorrhoidal tissue is also interrupted.
Initially go for digital and proctoscopic examination by a general surgeon and see what he says.
Hope I provided you with the information you wanted.
In case you need further detail please feel free to ask.
Regards!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 22 minutes later
I will visit my general physician. its not painful or bothering me, but I can feel it there.

So is it ok to leave it for a while - will it go away by its own? I am having fiber in diet and no constipation at all.

I am not sure what can trigger it though...
doctor
Answered by Dr. Ramesh Kumar 29 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hello again my dear patient,
Don’t worry its not a medical emergency.
So take your time but do get it examined by a proctoscpe.
If its hemorrhoid it won’t go away rather would progress from stage 1 to 2 over months.
Its not painful as its in stage 1 right now.
At lest start using ountment ruticool once daily and take sitz bath.
Can you please attach a photo of it want to see it.
waiting!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 47 minutes later
Attaching the image. Its on the left side of anal hole, and on the right side of the image.
doctor
Answered by Dr. Ramesh Kumar 30 minutes later
Brief Answer:
Follow up.

Detailed Answer:
hello dear,
99.9 % its a hemorrhoid.
For Rest 0.1% surgeon would examine proctoscopically.

Hope you were helped.
Do raye answer and feel free to follow up.

Do you want a diet schedule for the same?
If yes please revrt back would help you with it.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 16 minutes later
how can I make sure to avoid it? I drank strong coffee and I felt discomfort from the past after coffee.

A diet idea would be good.

Secondly would like to get rid of this one so i am not concerned or bothered about it.
doctor
Answered by Dr. Ramesh Kumar 5 minutes later
Brief Answer:
follow up.

Detailed Answer:
Hello sir again,
I cant get what you mean by you want to avoid it.
Its hemorrhoid (A disease) you have to follow proper medications.
As expained earlier even after medication surgery is required in patients.
I can’t get i am not concerned would like to get rid of it?
please if possible try to explain what you want to say.
waiting.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 12 minutes later
I was trying to find a way to cure it and heal it. And Avoid it being happening again as this is the first time I am facing this issue.

What is the best way to heal this and avoid any irritation or any recurrence of this.

I am confused now, so you are saying this is not treatable and I will have the hemorrhoid for ever there as it is ?

https://www.webmd.com/digestive-disorders/hemorrrhoid-home-care#1 what made me think it is curable and the inflamed or swollen vain gets healed over time. I am confused now.
doctor
Answered by Dr. Ramesh Kumar 24 minutes later
Brief Answer:
follow up.

Detailed Answer:
Hello XXXX,
Extremely sorry but i guess there is some mis confusion.In my initial answer only i wrote to you that they are curable initially we follow a conservative management for 3 months,Thereafter if not successful we follow non invasive surgery and even if it is not successful we have Invasive surgical procedures.
I would request you to go through my very first reply again.
Its fully curable but offcourse not naturally my dear patient you would need proper mjediction with diet changes.

Read it again and then tell me what you cant understand.
waiting!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 7 minutes later
it makes sense. Thank you
doctor
Answered by Dr. Ramesh Kumar 5 minutes later
Brief Answer:
Your most welcome.

Detailed Answer:
Have a good day and fast recovery.
Please do rate the answer and write a review.
Any suggestions to make answer more helping are also welcome.
Regards!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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