The anus is the opening at the lower part of the digestive tract, where stool exits the body. It connects to the rectum, which stores stool before passing it.
This article looks at what can cause a hard anus, the accompanying symptoms, and what treatments are available to treat a hard anus.
Possible causes of anal hardness are perianal hematoma, external hemorrhoids, and anal warts.
The anus consists of several different tissues, including:
- mucous membranes
- lymph nodes
- blood vessels
If anything causes irritation, a blockage, or an infection, lumps may form on the anus that can make it feel hard.
If a person notices a hard lump or a hardened anus, they should talk to their doctor and have the area examined. Most lumps are not a cause for concern.
The following are some potential causes of anal hardness.
Perianal hematoma is a condition wherein blood pools in the tissues surrounding the anus due to a burst blood vessel.
Straining during a bowel movement, lifting, and other vigorous movements may cause the blood vessel to burst. Someone with a perianal hematoma may have a swollen bulge near the anus that may also be painful.
External hemorrhoids appear as lumps under the skin around the anus. They are common and affect almost 50% of people in the United States by age 50.
A person with hemorrhoids may experience:
- swollen lumps
The human papillomavirus (HPV) can cause condyloma acuminata, commonly known as anal warts, to appear on or around the anus. Anal warts are typically skin colored and soft.
A person can contract HPV through sexual intercourse or by exchanging bodily fluids.
Anal warts can produce symptoms such as:
- mucus discharge
- small or large bumps
Perianal hidradenitis suppurativa
Perianal hidradenitis suppurativa (HS) is an inflammatory condition that affects areas of the skin that contain apocrine glands.
Perianal HS appears under the skin as painful nodules. A person may experience scarring.
When a health professional drains the nodules, they often contain foul smelling pus.
Another potential cause of a hard lump forming in the anus is constipation. Constipation occurs when a person does not regularly pass stool. This may occur if they do not drink enough fluids or eat enough fiber.
People with constipation usually produce dry, hard stools.
Constipation can also cause the following symptoms:
- infrequent bowel movements
- hard stool
Molluscum contagiosum is a skin infection that spreads when a person comes into close contact with someone who has the infection. The infection can occur anywhere on the body that comes into contact with the virus, including the anus.
If the infection occurs in the anus, it is usually due to:
- engaging in sexual activity with someone who has the infection
- touching the anus after touching another infected part of the body
- sharing towels or other fabrics with someone who has the infection
Molluscum contagiosum can cause lesions that are:
- swollen or itchy
- small in size
- white, pink, or flesh colored
A foreign object is sometimes the cause of a feeling of hardness in the anus. An object that gets stuck in the anus can put pressure on it, making it feel harder than usual.
A trapped object in the anus may feel very uncomfortable.
Objects that can get stuck in the anus include:
- sex toys
- swallowed bones
- enema tips
According to the American Society of Colon and Rectal Surgeons, anal cancer accounts for around 1–2% of all cancers affecting the intestines. Anal cancer is most common in women and people between the ages of 55 and 64.
Anal cancer can cause swelling and lumps that can feel hard.
Some other symptoms of anal cancer include:
- rectal itching
- rectal bleeding
- swollen lymph nodes around the anus or groin area
- pain or fullness in the anal area
- abnormal discharge
- formation of a lump or mass near the anal opening
- changes in bowel movements, such as narrowing of the stool
These symptoms are also common in other benign conditions. For this reason, a doctor should examine a person if they present with any of these symptoms. This is to rule out other conditions and confirm a diagnosis.
What does a hard lump without pain mean?
A lump does not always produce pain. In most cases, a painless lump is not a major cause for concern, but it is still important for a person to seek medical advice.
Some potential causes of a painless lump include:
- molluscum contagiosum
- certain hemorrhoids
- anal warts
If a person has a lump on their anus, they should seek advice from their doctor. Often, they can suggest or provide a treatment that addresses the lump and any underlying cause.
Typically, a doctor will ask the person some questions about symptoms and perform a physical examination.
During the physical exam, the doctor will use a gloved finger to feel for any lumps caused by hemorrhoids, molluscum contagiosum, or anal warts.
In some cases, they may need to use an anoscope. An anoscope is a tool that a doctor can insert into the anus to allow them to take a closer look at it.
If the doctor wants to do a more thorough check of the anal area and colon for colon cancer, they may use additional instruments.
Some procedures a doctor may use to check the colon include:
- Colonoscopy. This is a procedure that uses a lit tube to search the colon for growths.
- Sigmoidoscopy. This is an examination similar to a colonoscopy that uses a tube to inspect the lower intestine.
- Barium enema. This is an X-ray exam of the colon.
Treatments will vary depending on what is causing the feeling of anal hardness. The following sections will list some treatment options depending on the cause.
When a person has a perianal hematoma, the treatment options typically consist of over-the-counter (OTC) pain medications or cold compresses. In severe cases of perianal hematoma, the person may require surgical drainage.
Surgery can treat some causes of anal hardness.
Treatment options for external hemorrhoids include:
- sitz bath
- cold compress
- OTC pain medications
- creams and ointments
- sclerotherapy, which uses a chemical to burn and destroy the hemorrhoid
A dormant virus causes anal warts. When a virus is "dormant," it means that its symptoms are likely to recur.
Some treatments for anal warts include:
- fulguration, which uses an electric current to burn off the warts
- cryosurgery, which uses liquid nitrogen to freeze the warts
- acids, for smaller warts
Some treatments for perianal HS include:
- antibiotics, to treat infection
- adalimumab (Humira), to fight inflammation
- cortisone cream, to relieve irritation
If a person has constipation, there are several potential steps they can take.
Some treatments for constipation include:
- eating more fiber
- taking laxatives
- taking stool softeners
- drinking more fluids
If OTC constipation medications do not work, a doctor can prescribe stronger versions.
A doctor typically treats molluscum contagiosum with a prescription cream that helps the body's immune system fight the virus that causes the lesion.
A doctor can often use forceps to remove a foreign object from the anus. However, if the object is difficult to remove, surgery may be necessary.
Treatments for anal cancer depend on the stage of cancer and the person's overall health.
Some potential options to treat anal cancer include:
- radiation therapy
When to see a doctor
A person should talk to their doctor if the pain is spreading or worsening.
A person should see their doctor if they notice a growth on their anus. In most cases, the growth will likely be benign.
A person should also see their doctor as soon as possible if they experience:
- spreading or worsening pain
- bleeding that does not stop
- anal bleeding or pain with a fever
- changes in bowel movements
Most conditions that cause hard anal lumps are benign. However, they can be painful and cause worry for many people.
If a hard lump forms on the anus, a person should contact their doctor to get it checked.
A person should see their doctor as soon as possible if the lump causes:
- severe pain
- bleeding that does not go away
- changes in bowel movements