Dr. Arvind Guru
MBBS (AIIMS)., MS (PGIMER,CHD
General Surgery, Surgical Gastroenterology, Surgical Oncology
Welcome to icliniq.com.
I have seen your attached picture (attachment removed to protect patient identity).
It shows old hemorrhoids called as skin tags. This picture, along with the pain that you are describing is suggestive of anal fissure. This is a tear in the wall of the anus, at the base of these skin tags. Here is what you need to do:
- Heal the fissure.
- Cure constipation.
- Prevent these from happening again.
To heal the fissure, do sitz bath. Take lukewarm water in a medium sized tub, put two teaspoons of ordinary salt per liter of water. Total 10 g salt per liter of water. Now sit in this water and try to push out on the anus. Try to make the water clean and sooth your anal region. Sit for around 15 minutes, 3 to 4 times every day for a month or so. Try to do this at least twice per day if you are working professional. It will decrease pain, itching, and help to heal the fissure. Do these for around 6 to 8 weeks.
For pain relief during passing stools as well as healing of the fissure, I suggest the following or equivalent generic combinations for at least three weeks, after that only sitz bath should be enough:
- Ointment Diltiazem 2 %, 10 minutes before passing stools and three times a day. It comes with an applicator that goes around 1 to 2 cm inside the anus. It relaxes the anal muscle so that the blood supply to the torn area improves, and it heals faster.
- Ointment Prilox (Prilocaine 25 mg and Lidocaine 25 mg), five minutes before passing stools. This one is only for pain relief. Take a peanut size of ointment and apply with a finger at the opening. Though mostly safe, both these medications can have side effects in some patients, so stop usage if you feel dizzy, nervousness, or have blurring of vision.
For constipation, I suggest you try the following:
- Consume high-fiber diet for long-term control. Eat a large platter of vegetable salad with or as a replacement for lunch or dinner. You can take sprouts of legumes as part of breakfast. Whole cereal or whole wheat flour for bread.
- Isabgol (Psyllium husk), 2 to 3 teaspoons twice a day, in milk, curd, or flavored drink powder at bedtime. You can grind it to a powder in your mixer to make it more palatable.
- If you do not have any kidney or heart disease, then take 3 to 4 liters of water every day. Keep on drinking at short intervals throughout the day.
Curing constipation treats these and also prevents these from troubling again. Some people need surgical treatment for bleeding hemorrhoids, but only if dietary measures are not effective in controlling the problem.
I hope that helps. Kindly leave feedback. Follow-up if you need any more information.
For more information consult a surgical gastroenterologist online --> https://www.icliniq.com/ask-a-doctor-online/surgical-gastroenterologist