Patient's Query
Hello doctor,
I have developed a lump around the anus. It is extremely painful and spoils my day. I assume it is piles. I keep doing sitz bath twice a day and have been taking Dr. Reckeweg R 13 regularly. I do not sense any relief besides walking for long and during a sitz bath. Please help. Would it go away on its own?
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
Well, the picture is a little blurry (attachment removed to protect patient identity). As far as I can see, it seems external hemorrhoids are likely thrombosed. Thrombosed means clotting of blood within these veins of the anal canal. The other possibility is an anal fissure, which is again a painful disorder. I suggest you upload more pictures, as I can be very sure about the diagnosis.
Meanwhile, considering that it is external hemorrhoids, you should continue the sitz bath. This time, more frequently, like every four hours for at least 15 minutes in semi-warm water, and add an antiseptic solution (5 ml). You should keep doing it for five to seven days until this swelling subsides.
Plus, take tablet Daflon 500 mg (Diosmin and Hesperidin) thrice daily for seven days. Apply Xylocaine gel 2% (Lignocaine) six hourly for five to seven days, or until the pain settles. Glyceryl trinitrate GTN cream, six-hourly alternatives with Xylocaine.
Are you constipated as well? If yes, then use Ispagol husk two tablespoons full daily with water. Do not strain while passing stools.
I hope this helps.
Please revert in case of further queries.
Thank you.
Patient's Query
Hello Doctor,Thank you.
Please find another attachment. I have been patient with anal fissures for more than a year, but now they do not cause pain during defecation. I had begun to apply Levorag Emugel and changed my diet to a soft diet and salads.
There is no bleeding involved this time, nor do I feel the direct sensation in the anus, but lumpy around it. Also, it pains me a lot when I move. I do not have constipation.
Please help.
Hello,
Welcome back to icliniq.com.
I have seen the picture you attached (attachment removed to protect patient identity). It does not seem to be an anal fissure. It is highly likely an external hemorrhoid or hair folliculitis, which is inflammation of the hair follicle.
Besides the above medications, which I have suggested to you, you can take a small course of antibiotics or apply local cream in the form of Fusicidin. Apply three times daily for seven days. You can use Levorag emugel; it is a good medication, and there is no harm in combining it all together.
I hope this helps.
Please revert in case of further queries.
Thank you.
Patient's Query
Thank you, doctor,
I also do not feel it is an anal fissure. However, I shall apply the Emugel as suggested. Also, I have noticed that I am a bit constipated when I am expecting my period and feel pressure around my rectum until I get my period. Could it be interrelated?
When progesterone rises around periods, my body feels constipated and does not hold water. By that, I mean that even if I consume lots of water during the day, the lips remain dry, and I only end up urinating more frequently.
I shall try to buy the medicines as you suggested, but I shall not consider the antibiotic course as of now.
Please advise
Hello,
Welcome back to icliniq.com.
Well, menstruation itself is a huge subject. There are various hormonal changes within the body that anticipate the various features of menstruation, such as pain, bleeding, sleep disturbance, and skin changes.
Dry lips may be one of those symptoms. Since I am not an expert in it, I could not tell you enough.
Some change in the bowel is expected at the time of menstruation since the muscles of the uterus, the rectum, and the anal canal are supplied by the same nerves.
Painful contraction of the uterine muscles can increase the spasm of the rectum muscles, causing constipation.
This is just a physiological change and not pathological. Hence, it does not need any specific treatment except advice to modify the diet.
Increase fiber intake and take plenty of water, i.e., two to three liters a day. Fucidin (Fusidic acid) cream is a local antibiotic and would not cause any side effects. So do not be worried about that.
I hope this helps.
Thank you.
Patient's Query
Thank you, doctor,
I am a bit confused now. So, should I buy medicine for external hemorrhoids or Fucidin or both? Please help.
Hello,
Welcome back to icliniq.com.
I suggest both. You will be fine.
I hope this helps.
Thank you.
Patient's Query
Hi doctor,
Thank you for your kind help.
Hello,
Welcome back to icliniq.com.
You are welcome. Keep in touch for furhter doubts.
Patient's Query
Thank you doctor,
Daflon 500 mg is not available here. The chemist suggests Venentabs by Ratiopharm. Should I take it? Does the dosage remain the same?
Hello,
Welcome back to icliniq.com.
Do not take that. You should check for tablet Diosmin. Let me know if this is available. Dose should be 500 mg Flavinoids twice daily or equivalent.
Patient's Query
Hi doctor,
Thank you for your reply.
Diosmin is not available. However, I will look for it in other nearby chemists too. Also, I need your clarification on the second sentence. Do you mean that Flavonoids 500 mg is an alternative or that Flavonoids 500 mg is a main ingredient for the medicine?
Also, Fuscidin cream needs a prescription from a doctor, so it cannot be bought.
Thank you.
Hi,
Welcome back to icliniq.com.
Flavonoids are the main ingredient in the medication. Is Diosmin or Flavonoids available?
I hope this helps.
Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
I have one more query now. My pain has somehow subsided. At least I can walk, but I noticed a little blood on my external hemorrhoid. Does Xylocaine help it? Also, the chemist gave me Ichtholan 50 % but I am not sure if I should apply it. Thank you for your prompt replies and support so far.
Thank you.
Hi,
Welcome back to icliniq.com.
No, I do not think it is suitable for hemorrhoids. You should arrange for Xylocaine. Xylocaine is primarily used for pain relief, but it also has some ability to control bleeding. A small amount of blood is not alarming and should resolve within a few days of following the advised regimen. It is a pleasure to talk to you. No problem at all.
I hope this helps.
Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your response.
Yes, I have been applying Xylocaine as suggested. The closest alternative to tablet Diosmin I could find is Diosminven 1000 mg. I hope it is safe for me to take this?
Please guide.
Hi,
Welcome back to icliniq.com.
Yes, you can use Diosminven; this is the same compound. You should take this three times daily if available in 1000 mg.
I hope this helps.
Please revert in case of further queries.
Thank you.
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Answered byDr. Ajeet Kumar
Medically reviewed byDr. Vinodhini J.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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