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What causes hard lump on the outside of rectal opening?

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Answered by

Gastroenterologist
Practicing since : 2006
Answered : 2217 Questions
Question
Dear Doctor,

Could you please give me your opinion regarding the following:

A hard lump 0,5cm-1cm right under (on the outside) of the rectal opening. The lump feels like cartilage and its possible to wiggle it. It does not have any specific color. Lump does not feel warm nor does it itch or sting. Lump feels sore and pain is present all the time but the lump does not seem to be filed with pus, although it may very well be. Feels like something under the bump hurts, like the bump is pressing against something under it. Touching the lump generates pain. Does not seem to be a problem with the skin itself but rather whats under the skin. Patient has been using rectal cream containing hydrocortisone and lidocaine for 10 days and the lump has not gotten any smaller nor bigger. The cream takes away some of the pain, probably because it contains lidocaine. Patiens has previously been passing a little bit of bloody stools (clear red) but this seems to have improved by the use of the cream mentioned earlier.

Regards
Posted Mon, 25 Aug 2014 in Digestion and Bowels
 
 
Answered by Dr. Klerida Shehu 19 hours later
Brief Answer:
A picture of lump is needed...

Detailed Answer:
Hi XXXXXX,

Various pathologies can be the cause of such lump:

- infection (of the local hair root, fistula ,etc.)
- tumoral issue
- regional lymph-adenitis

Further examinations are needed to determine the right cause, i.e. transrectal echo-endoscopy is the best choice for the diagnosis and to take material to run biopsy.

If the patient has done any test, then, can you please send the reports to me? Can you also send a picture of the lump (if it is visible)? I need to analyze them myself, so I can give final conclusions!

Thank you!
Dr.Klerida
Above answer was peer-reviewed by
 
Follow-up: What causes hard lump on the outside of rectal opening? 43 hours later
Dear Doctor,

Please see the attached document.

Regards
 
 
Answered by Dr. Klerida Shehu 28 hours later
Brief Answer:
External hemorrhoids...

Detailed Answer:
Hi XXXXXX,

Thank you for providing the attached document.

I have gone through the picture you sent in, and to my opinion, it might be external hemorrhoids.

Therefore, I highly recommend to :
- run anoscopy
- and to consult with proctologist for further specific treatment

I advise to avoid constipation and straining for too long when passing bowel movement.

All the best!
Dr.Klerida
Above answer was peer-reviewed by
 
Follow-up: What causes hard lump on the outside of rectal opening? 17 hours later
Dear Dr,

Thank you for the answer.

As I wrote earlier the patient has been using rectal cream for hemorrhoids containing hydrocortisone and lidocaine for 2 weeks without any improvement. If it was a hemorrhoid, there should have been some improvements by now, do you agree? Could it be an abscess?

Regards
 
 
Answered by Dr. Klerida Shehu 2 days later
Brief Answer:
Transrectal ultrasound is determinative...

Detailed Answer:
Hi back XXXXX,

From the photograph, it does not seem to be abscess. Furthermore, you are not mentioning any inflammation symptom (being warm, unbearable pain, fever, etc.)

I strongly advise to run transrectal ultrasound for determinative conclusions.

All the best!
Dr.Klerida
Above answer was peer-reviewed by
 
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