Lump outside anus. has had it for more than 4 years , but it will occasionally swell and is very painful at that time. can you tell what it might be?

Doctor can examine: In a young, healthy person, such a lump may be a hemorrhoid. A primary care doctor can examine the anus, rectum, and lump. If constipated, one pushes higher pressure into the anus and rectum, and the veins can swell up into a lump (called a hemorrhoid) that hurts, itches, burns, and sometimes bleeds. The doctor can offer treatment ideas after the exam. Meanwhile, avoiding constipation is helpful.