Brief Answer:
Need further details

Detailed Answer:
Hello XXXX, I thank you for posting your query here..
Welcome to HealthcareMagic..

I will analyze all your points and provide necessary explanation..
Please note..

1. Pain per rectum could be due to various causes.
Most notable are
A. Hemorrhoids
B. Fissures
C. Fistula
D. Malignancy late stages

2. Swelling in the anus.
Need further information..
A. Can she feel the Mass?
B. Is there bleeding per anus?
C. Any history of weight loss?
D. Loss of appetite?

3. Heat while passing stools looks OK, not a major problem..

4. Now, before you answer my questions I have three differential diagnosis.
A. Most likely, Hemorrhoids also called piles
B. Anal tag, due to Chronic Anal Fissure
C. Rectal Cancer

Please get back to me with these answers and I can help you better.
Take care..

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Brief Answer:
Feel, it's Anal fissure

Detailed Answer:
Hello XXXX, welcome back..
I thank you for getting back with the answers..

Please note..

1. No bleeding then it's a good thing..
Eventually rules out cancer..

2. No loss of weight again is a good sign.

3. Yes.. No more questions..
Now I feel, it's Anal fissure that has healed and causing something called as sentinal pile.

The mass that she is feeling is sentinal pile due to long standing fissures.
Even pain that she tells, is related to anal fissure..

Advise you following things..
A. Don't worry about the mass, eventually it should subside in 3 to 6 months time..

B. Avoid constipation..
Ask her to drink lots of water, vegetables and fruits.
Avoid or reduce non veg if consuming.
Reduce coffee or tea..

And she can use
A. Sitz bath
B. Local Lignocaine gel for pain..

Hope this helps, in case you need further assistance, please contact me.
Or, you can close the question and rate.
Take care..

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