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Q. Medicines are not reducing pain and bleeding due to piles. Please help.

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Aug 14, 2020 and last reviewed on: Sep 04, 2020

Hi Doctor, My mother is having piles problem, she is bleeding during bowel movements having pain. The problem is, bleeding every time trying to pee, painful bowel movement. Its happening past 3 days. Pain is only when going for bowel movements. Stool is normal, Not hard. She Had the history of same issue. But in past the problem was solved after taking medications. But this time the medicines aren't helping to ease the pain/reduce bleeding.

Dr. Ajeet Kumar Lohana

Medical Gastroenterology

Hello dear. I welcome you to icliniq. Well you can give her

Cap Tranxemic acid 1 gm twice daily for 3 days and see if bleeding stops. I wonder is she only have hemorrhoids issues? since the hemorrhoids cause only painless bleeding, however, it is anal fissure which is breach in the lining of the anal canal, which can cause painful bleeding. You start her on the above medication, which would control her bleeding.

For pain, ask her to use Xylocain 2 % gel three to four time daily with nozzle , plus Dilitazem gel three to four time daily, alternative with Xylocain with nozzle.

She should use Ispagol husk daily, 2 table spoon full daily with water.

I also want, since she is in this stage of her age, with bleeding in stools; that she should have some through work up for the looking the cause of bleeding. At moment just get following blood and stool tests, and later it is possible that she might need a colonoscopic examination of the large bowel as for screening purpose. Find list of investigations below, once they are done, let me know.

The Probable causes:

Bleeding per rectum
Anal fissure
Ulcerative procitis /colitis

Investigations to be done:

Complete blood count
Serum CRP, ESR
Stool for detail report
stool for ova and parasites
stool for Fecal calprotectin
Stool for C difficle toxin
IHA titer for E. Histolytica

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