Q. What is the treatment for itching in external and internal piles?

Answered by
Dr. Ajeet Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 11, 2022

Hi doctor,

I am 28 years old and my height is 6 feet 2 inches, and I weigh 98 kg. I have external and internal piles. And, I have itching but no bleeding. Also, I am not under any medications. Kindly suggest a solution to my problem.


Welcome to

I see your weight seems to be very high and you also have constipation. In this case, it is common to have external and internal piles. In the picture that you have uploaded, I can only see the external piles (attachment removed to protect the patient's identity). Since internal piles are not visible on this external examination, one has to have a proctoscopy or sigmoidoscopy, before commenting on internal piles. However, the treatment is otherwise the same in both conditions.

I suggest you to follow the instructions mentioned below.

1. Avoid constipation by taking regular laxatives such as Isabgol husk (psyllium husk) two tablespoons full in a glass of water.

2. Increase your water intake up to two to three liters per day.

3. Reduce weight and this decrease the pressure at the bottom.

4. Hard stools with straining can also worsen external piles.

5. You can take Doxium (Calcium dobesilate) capsule 500 mg twice daily for 15 days, this also helps shrink the piles.

I hope this has helped you. Take care.

Hi doctor,

Thank you for your reply.

Can I use Pilex Forte ointment for itching? Please tell me if my piles are in the stage of performing surgery. I will undergo surgery if needed. Please give me your suggestions.



Welcome back to

Yes, you can use the ointment. And, surgery is not required at this moment of time, since you do not have bleeding. I suggest you to follow the medications I mentioned earlier.

Kindly follow up in two weeks to decide on the future plan. Take care.

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