What causes a painful lump near the anus?

Generally, the presence of a painful lump near the anus may be caused by prolonged sitting and friction, consumption of spicy foods leading to inflammation, thrombosed external hemorrhoids, perianal abscess, or perianal furuncles (boils). It is recommended to seek medical attention promptly, identify the underlying cause, and receive appropriate treatment under a doctor's guidance. Specific causes are analyzed as follows:

1. Prolonged Sitting and Friction Irritation: Extended periods of sitting increase pressure on the anal area, causing repeated skin friction and damage, which can lead to inflammatory lumps accompanied by pain. To prevent this, stand up and move around for 5–10 minutes every hour, use soft and breathable cushions, and avoid sitting for long periods on hard surfaces to reduce local friction and pressure.

2. Inflammation Caused by Spicy Diet: Long-term consumption of spicy foods such as chili peppers and Sichuan pepper can irritate the skin and mucous membranes around the anus, triggering inflammatory lumps and pain. Adjust your diet to include milder foods, consume more fiber-rich foods like celery and bananas, drink plenty of water, and avoid spicy or irritating foods that may worsen symptoms.

3. Thrombosed External Hemorrhoids: A sudden blood clot in the anal venous plexus forms a dark purple lump, which is notably painful upon touch. Follow medical advice to relieve discomfort with warm sitz baths, and apply topical medications such as Ma Ying Long Musk Hemorrhoid Ointment, Gang Tai Ointment, or Yunnan Baiyao Hemorrhoid Ointment to reduce pain and swelling.

4. Perianal Furuncle (Boil): Infection of hair follicles around the anus by Staphylococcus aureus leads to red, swollen lumps accompanied by redness, heat, and pain. After bowel movements, clean the perianal area with warm water. Take antibiotics such as Cefuroxime Axetil Tablets, Amoxicillin Capsules, or Roxithromycin Capsules as prescribed, and avoid squeezing the lump to prevent spreading the infection.

5. Perianal Abscess: Infection originating from anal glands spreads and forms an abscess, presenting as a firm, painful lump near the anus. The pain is severe and progressively worsens. Treatment typically requires surgical incision and drainage to remove pus, completely eliminate the infectious focus, and prevent complications such as fistula formation.

To maintain daily health, keep the perianal area clean and dry. Wash daily with warm water and gently pat dry with a soft towel. Wear loose-fitting, breathable cotton underwear, wash and change it frequently, and dry it in sunlight. Develop regular bowel habits, avoid prolonged straining or squatting during defecation, and maintain smooth bowel movements to minimize local irritation.