its an external hemorrhoid, pic is of an anus with a hematoma round the 7 o'clock position. there is pain and bleeding with wiping which points me toward an external hemorrhoid. with the other answer choices being infectious causes the only two left were venous htn and lymphatic obstruction. because increased straining and increased pressure on the inferior and middle rectal veins went with venous htn. (not to be confused with superior rectal vein which is linked to portal htn and internal/ painless hemorrhoids)