Help I have a lump in my bum!

Hey there guys,

Today I thought I would tackle the touchy subject of anal lumps.

Lumps around the anus are fairly common and in most cases they are not dangerous.

The most common causes are haemorrhoids and warts. While many people worry about things like anal cancer, this is thankfully rare. Let’s get started shall we?


Haemorrhoids are pretty common. To cut it down to the simplest terms a haemorrhoid is basically a varicose vein of the ass. Near the anus there are three big veins and things like straining and constipation can lead to these veins filling up with blood. If there is any scratching as the stool goes past this can lead to inflammation, swelling and a clot developing that is usually felt like a hard lump.

Haemorrhoids can be both external, looking like a small grape, or internal where they can be felt if you pass a finger just inside the anus.

The main symptoms of haemorrhoids are bleeding, itch and pain. Some people may have a sensation of “something being stuck” or even see a bluish bulge that can cause worry.

Because the veins can fill up, it can cause them to bleed easily. The blood is normally noticed in the bowl or on the toilet paper. The sign that helps differentiate haemorrhoids from something sinister like anal or bowel cancer is that the blood is separate or just sitting on the stool. Not mixed through it.

If you are worried or suspect you have haemorrhoids, getting checked is very straight forward and simple. After discussion your doctor will likely want to examine by having a look at the area. Because some haemarrhoids are just inside the anus he or she may need to pass a finger inside the anus to check for these. It’s also a good time to check the prostate and for any other lumps that might be causing bleeding.

The good news is that there is a variety of treatments, most of which are effective.

One of the first keys to to avoid constipation. This is easily done by making sure you get a good variety of fruits and veges accompanied by plenty of water. If you have fiber but no water this actually makes constipation worse. If you want to add a little extra fiber there are products like Metamucil which is basically psyllium husks with added sugar.

A great tip from one of my patients is just to buy the psyllium husks from the natural food store. It will save you heaps and you get to avoid the added ingredients you just don’t need.

The suggested dose is two  teaspoons of husks mixed into a glass of water and drunk straight away.

Other treatments include creams that can be applied to the area to numb the pain and reduce swelling.

If there is a clot this can sometimes be easily removed by your doctor.

If your haemorrhoids are severe, painful or not getting better despite the treatments above they can be removed surgically. Your family doctor will be able to talk to you about these options if you are keen to explore them.

Anal warts

Warts in the anus look almost the same as common warts

Warts are the common cold of sexual health. They are very easy to catch, can happily grow on the penis, testicles and ass and can lead to much annoyance and for some significant embarrassment. Even more frustrating is that for many the time of exposure may be years and even decades before the actual time the warts show up. This can lead to a lot of confusion and accusations of infidelity in relationships.

Please be reassured that most of the time exposure was well before the warts turned up, we just don’t know the exact reason they decide to show up when they do.

People become infected with the wart virus, human papilloma virus (HPV) after skin to skin contact with wart tissue. This can be from warts on the penis or scrotum, but also warts on fingers or other areas of the body.

If in or around the anus, warts can present as an itch and sometimes bleeding or pain.

Anal warts are fairly straight forward to diagnose due to their distinct look. As part of your examination your doctor may need to place a speculum, a special viewing device, into the anus to allow viewing of the skin just inside.

Recently there has been thought to offer a form of anal pap smear to men to help detect anal warts and cancer earlier. Currently this is not standard practice and I’m not sure what direction this may go at the moment.

There are a number of different treatments for anal warts. These include paints that destroy wart tissue, creams that encourage the immune system to fight the wart tissue and if the warts are large they can be surgically removed.

Your doctor is going to be your best port of call to discuss treatment options.

Treatment of anal warts is important as there is an association with the HPV virus, anal warts and developing anal cancer later in life.

Click here for a good resource on HPV and anal warts.

Anal Cancer

Thankfully anal cancer is a rare disease with an incidence rate of about 20 per million people.

The main risks for anal cancer include smoking, previous anal warts, receptive anal sex and multiple sexual partners. Because of alternations in immune function, anal cancer is more common in people living with HIV.

About half of people with anal cancer will present with bleeding from the back passage and a third will experience pain, discomfort or a noticeable lump. One in five people with anal cancer will have no symptoms at all.

For this reason any form of rectal bleeding or pain needs to be carefully examined and discussed with your doctor.

Good news is that anal cancer has very good treatments including radiotherapy and medications, meaning that surgery is not used as frequently as in the past.

So what is the bottom line? (pun intended)

In majority of cases lumps in the anus are not sinister. The main causes are haemorrhoids and warts.

Because there may be a low risk of anal cancers, careful examination by a trained professional is important.

As part of your examination your doctor may need to pass a finger or speculum to help with diagnosis.

For most cases treatments are simple and effective, however if there are any concerns your doctor may wish to refer you to a specialist.

Bleeding from the back passage is an important symptom and if noted, be sure to see your doctor as soon as possible.

Guys I hope this article has been informative and helpful. Of course if you have any questions please feel free to leave a comment below.

Yours in good health.

Dr George

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