A painful boil-like lump near the anus may be a thrombosed pile, fissure, or abscess, not just simple piles. Since pain is persisting despite treatment, avoid self-medicating with painkillers and consult a doctor, as some conditions need specific treatment or drainage.

This change in texture is likely due to the difference in packaging. Aluminium tubes better protect the cream from air and moisture, helping maintain a stable, creamy consistency, whereas plastic tubes can allow slight air exposure after opening. This may cause creams containing sucralfate to separate and become more liquid over time, even though the product is safe to use. To improve consistency, gently knead the tube before each use and store it in a cool place. If you prefer the original texture, you may ask your pharmacist whether the aluminium-tube version or an alternative product with the same ingredients is available.