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What does a sudden painful lump near the anus mean?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have a pulp just outside the anus crack, which just originated today, and it is painful. Please help.

Thank you.

Answered by Dr. Aditya Jalan

Education:

MBBS

Professional Bio:

Dr. Aditya Jalan is a certified General Surgeon, General Practitioner, and Family Physician with expertise in surgical procedures, chronic disease management, preventive care, and primary healthcare. He offers comprehensive medical and surgical solutions tailored to individual needs. Dr. Jalan is dedicated to delivering compassionate, evidence-based care for patients of all ages, focusing on long-term wellness, early diagnosis, and effective treatment outcomes.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I went through your question. It seems from the picture that you should be having severe pain (attachment removed to protect identity).

This can be the result of thrombosed hemorrhoids, perianal fistula, or a pilonidal sinus. Still, to guide you better, I need a few more details.

What is the exact site? Is it the anal orifice or around the anal orifice? Is there any discharge, serous or purulent? Is there any kind of bleeding? Do you have a fever? Have you had to complain of constipation or straining in the past?

At present, to relieve your symptoms, please take the tablet Aceclofenac 100 mg orally twice daily for two days. After you provide me with details, I will add further specific advice.

I hope this helps.

Kindly revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

It is around the anal orifice, having no discharge or bleeding. I am not having a fever, but in the past, I had the problem of internal piles and had IRC done last year.

Thank you.

Answered by Dr. Aditya Jalan

Education:

MBBS

Professional Bio:

Dr. Aditya Jalan is a certified General Surgeon, General Practitioner, and Family Physician with expertise in surgical procedures, chronic disease management, preventive care, and primary healthcare. He offers comprehensive medical and surgical solutions tailored to individual needs. Dr. Jalan is dedicated to delivering compassionate, evidence-based care for patients of all ages, focusing on long-term wellness, early diagnosis, and effective treatment outcomes.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome back to icliniq.com.

Just to reconfirm and let you know in simple terms. If you have swelling at the border of the anus, it is most likely to be thrombosed piles (hemorrhoids). And also, since you had a history of IRC (infrared coagulation), it is more likely. And if the swelling is slightly away from the margin of the anus, it is more likely to be a perianal fistula.

I hope this helps.

Kindly revert in case of further queries.

Thank you.

Treatment plan

I would recommend you to take these medications. Your symptoms should reduce. Tablet Ciprofloxacin 500 mg twice daily for one week after food, Ornidazole 500 mg twice daily for one week after food, Pantoprazole 20 mg once daily before food for one week, Aceclofenac 100 mg twice daily for three days after food. Surgical intervention may be required later once the infection subsides.

Preventive measures

For prevention, take sitz bath thrice daily for 20 minutes in lukewarm water for seven days.

Regarding follow up

Regarding follow-up, these medications will reduce your symptoms and relieve the infection. Let me know if you have a fever, or any discharge.

Patient's Query

Hi doctor,

Thank you for the reply.

Should I sit on an ice bag or a warm water bag to reduce the swelling, as I have started the sitz bath already? Please help.

Thank you.

Answered by Dr. Aditya Jalan

Education:

MBBS

Professional Bio:

Dr. Aditya Jalan is a certified General Surgeon, General Practitioner, and Family Physician with expertise in surgical procedures, chronic disease management, preventive care, and primary healthcare. He offers comprehensive medical and surgical solutions tailored to individual needs. Dr. Jalan is dedicated to delivering compassionate, evidence-based care for patients of all ages, focusing on long-term wellness, early diagnosis, and effective treatment outcomes.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome back to icliniq.com.

Only a sitz bath should be enough for a few days. If you are also having constipation or you are reluctant to pass stool due to pain, please take laxatives and syrup Lactulose 10 ml at night after food for seven days.

I hope this helps.

Kindly revert in case of further queries.

Thank you.

Medically reviewed by Dr. Vinodhini J.
Published At May 12, 2020
Reviewed At December 20, 2025

Education:

MBBS

Professional Bio:

Dr. Aditya Jalan is a certified General Surgeon, General Practitioner, and Family Physician with expertise in surgical procedures, chronic disease management, preventive care, and primary healthcare. He offers comprehensive medical and surgical solutions tailored to individual needs. Dr. Jalan is dedicated to delivering compassionate, evidence-based care for patients of all ages, focusing on long-term wellness, early diagnosis, and effective treatment outcomes.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Vinodhini J. is a Dental Surgeon with extensive years of clinical experience. She specializes in the diagnosis, prevention, and treatment of dental and oral health issues, including restorative, surgical, and cosmetic procedures. With a patient-centered approach, she focuses on maintaining oral health, alleviating discomfort, and enhancing smiles. Her expertise ensures comprehensive care tailored to each patient’s dental needs and overall wellbeing.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Aditya Jalan is a certified General Surgeon, General Practitioner, and Family Physician with expertise in surgical procedures, chronic disease management, preventive care, and primary healthcare. He offers comprehensive medical and surgical solutions tailored to individual needs. Dr. Jalan is dedicated to delivering compassionate, evidence-based care for patients of all ages, focusing on long-term wellness, early diagnosis, and effective treatment outcomes.

This doctor is not available for online consultations on the platform anymore.

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