Q. My wife could notice blood in her stools. Could you please advise us with proper guidance?

Answered by
Dr. Jaydeep Tripathy
and medically reviewed by iCliniq medical review team.
Published on Feb 22, 2015 and last reviewed on: Oct 09, 2018

Hello doctor,

  • My wife (age 33 years) has been suffering from piles related issues since last 10 years.
  • It occurred after her delivery (in 2003) and was harmless at that time. We are having an eleven year old daughter.
  • Recently she started experiencing pain and itching while going to toilet.
  • Also she could notice blood in stool (occasionally).
  • So, we decided to visit a hospital and there she had a couple of tests including rectal scanning.
  • After investigation, doctor informed us that she has been affected by second degree piles, skin-tag and fissure and hence laser surgery is inevitable.
  • We are really worried. Is there any alternate treatment without surgery? 
  • Presently, an ayurvedic specialist (who is located near our village) has prescribed few medicines (mentioned below) for reducing the pain and itching but not for cure, Hamamelis virginiana ointment at night (to be used on the affected area), ayurvedic medicine for internal intake like Arsohari lehyam and Smooth laxative

Could you please advise us with proper guidance? Is there any doctor to whom we can consult for a second opinion? My wife is a thyroid patient. Looking forward to your valuable suggestion.

Dr. Jaydeep Tripathy

Family Physician General Practitioner
#

Hello,

Welcome to icliniq.com.

I understand your concern.

It seems like your wife has second degree hemorrhoids which has also led to her fissure.

The good news is that it can be managed medically. The first line of management is medical management.

Itching is a very common manifestation, which is also known as pruritus. There are certain guidelines:

  • First, she needs to take regular laxatives and have a high fibre diet. Medicines like psyllium, or mild laxatives such as lactulose will be helpful. It can be taken once at bed time.
  • She can apply local ointment like Proctosol-HC. This will reduce the pain and itching in the affected area. If that is not available, topical hydrocortisone can be applied. This will reduce her pain.
  • Strikingly enough, one thing that I missed in your history is sitz bath. I am not sure if your wife has ever heard of it. Often, this is enough to treat piles. The patient is supposed to sit in warm water for 15-20 minutes around 3-4 times a day, preferably in and around bowel movement time. It reduces the pain, swelling and the associated pruritus to a large extent. 
  • The ointment can also be applied in the fissure spot, after proper cleaning of the area. The area also has to be kept as dry as possible.
  • In later stages if the local doctor feels it is necessary, medicines like nitroglycerin or CCBs (Cacium Channel Blockers) can be applied directly on the affected spot. 

Before all this you need to go and get yourself examined by a good reputed general surgeon in your area. Ayurveda is outside my field of expertise and I am not convinced about you using ayurvedic medicines to treat hemorrhoids at this stage.

There are other various possibilties like rubber band ligation, sclerotherapy, cryotherapy, etc. The doctor who examines her may advise a colonoscopy to find out the status of the fissure. My final advise to you is that her condition is treatable and you need not have to worry. She needs to be under a good surgeon. There are various other modalities, which can be decided based on her local findings. Hope this was helpful. consult a general surgeon online for further follow up --> https://www.icliniq.com/ask-a-doctor-online/general-surgeon

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