Dr. Noushif. M
Surgical Gastroenterology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had a history of piles or fissures during pregnancy when I had not passed stool for eight days and then got hospitalized where I passed stool after taking a pain killer injection. The doctor gave me some syrup and tablets, and I do not remember the name. After that, I do not have much problems.
For the last five days, I am having the same problem. It seems like internal fissures that cause intense pain while passing stool and the stool is too hard. I have to sit in hot water for 15 minutes to reduce the pain. There is a huge swelling around the anus that I cannot even pass the gas.
I expect some medicine to make the stool loose and lessen the pain while passing. Actually, the fissures do not even get the time to heal themselves as every morning, the hard stool again scratch the fissure. Please help with my situation. I am taking homeopathic medicine for the past one month but no relief.
Hi,
Welcome to icliniq.com.
You need to follow the below mentioned three steps.
1. Diet - avoid or reduce all constipating foodstuffs like bread, cheese, baked foods, and chocolates. Take around three liters of water daily. Add more vegetables to your diet.
2. Avoid straining while passing stools and take syrup Cremaffin plus 30 ml (stool softner) two times a day.
3. Apply cream Diltigesic plus (Diltiazem hydrochloride) over the painful area at the anus three times a day. Sit in a mild-warm water three times a day for 10 minutes.
Consistently follow these measures for five days and consider a review with me.
Patient's Query
Thank you doctor,
Should I take the syrup before meals or after meals?
Hello,
Welcome back to iciniq.com.
You can take the syrup after meals.
Patient's Query
Thank you doctor,
I am following the first point (diet) effectively already and sitting in mild warm water for four times. I am taking daliya for the past three days, but the first stool is too hard to pass. Also, I am applying Anovate cream daily.
Hello,
Welcome back to icliniq.com.
Anovate will not be useful here. Apply Diltigesic 15 (antacid) minutes before going to toilet.
Patient's Query
Thank you doctor,
Please suggest an oral pain killer use when I have unbearable pain in the morning. Or will the above be sufficient for pain too?
Hello,
Welcome back to icliniq.com.
You can take Voveran (Diclofenac) tablet 50 mg. Take it with food. Take tablet Rantac (Ranitidine) 150 mg 30 minutes before food in the morning and evening.
Patient's Query
Thank you doctor,
I will follow up if problem persists.
Hello,
Welcome back to icliniq.com.
Do review after five days or early if any issues.
Patient's Query
Hi doctor,
Thank you for your kind help.
Hello,
Welcome back to icliniq.com.
You are welcome. Keep in touch for further doubts.
Patient's Query
Thank you doctor,
I am feeling better and relieved from constipation after taking the Cremaffin plus 30 ml and Voveran tablet in the evening.
How long do I need to continue Cremaffin plus and Voveran tablet? Is it just a temporary cure or would I need surgery for a permanent cure? Constipation problem occurs only in certain periods, so is it safe to take the Cremaffin plus 30 ml in those periods?
Hi,
Welcome back to icliniq.com.
Cremaffin can be stopped after five days once the hard stools settle. Do not continue it regularly. Try to achieve soft stools with dietary measures as much as possible.
Voveran needs to be taken only if you have severe pain. I never have it regularly for more than three days. Do not take it without a doctor's suggestion too.
No need for surgery unless it is acute severe pain unsettling with medicines. However, I would suggest you to get examined by a nearby surgeon to make sure nothing else is there which is causing the symptoms.
Cremaffin is safe and nontoxic. But try dietary and preventive measures first. Take medicines only if you have disturbing symptoms.
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Surgical Gastroenterology
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