<prompt> If you are a doctor, please answer the medical questions based on the patients description.Hello Doctor, I just noticed yesterdat that I have this hard thing in the entrance to my anus. It looks like a bum but when touched it kind of moves, is really hard and covered by the epithelial tissue. Could it be pile? Please help me out. I m really scared  <response>: Hi. Thanks for your query. You have great observation and really put the problem in a proper word of explaining :The lump which hard, mobile at the anal verge which is movable and covered by epithelial cells can be due to :-Prolapsed thrombosed pile.-Sebaceous or such cyst. The best way would be:Get the diagnosis confirmed by clinical evaluation, direct examination including ano-proctoscopy by a General Surgeon. Get operated as it is never a good idea to keep any of such swellings near the anal verge for 2 reasons1. You get rid of the problem 2. You get the proper diagnosis and histopathology report. In the meantime, take laxatives if you have hard stools. Antibiotics and metronidazole and probiotics if there are signs and symptoms of intestinal infection 