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I Am Having Piles Since Last 20 Years Or So,

Posted on Wed, 24 Feb 2021

Question: I am having piles since last 20 years or so, there is a big lump outside my anus but it don't bother me most of the times. But from last 15 days or so i having pain inside the anus wall while defecation and after defecation. I am using Pilex cream sometimes and recently i tried Anovate cream 2 to 3 times in total but no resolve or improvement in the pain, now i am in fear that if i go for a bowl moment the pain will increase. It started when i was around 17 years old due to constipation and hard stool then i got in the habit of holding the urge and the fear of pain/blood while forcing the stool, but then i started inserting the finger for bowl moment, along with isabgol or some laxetive churna. Now most of the time i don't feel my bowl moment like most people feel bit cramp while the process of emptying the bowl and everything happens naturally. So i still have my bowl moment with inserting finger, i know that i have to operate for the same but my worry is i don't feel bowl moment or have a bowl moment without the process i told earlier and what will i do after operate, please help me with my current situation for pain and swelling and with my query of the operate and the future.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

I am having piles since last 20 years or so, there is a big lump outside my anus but it don't bother me most of the times. But from last 15 days or so i having pain inside the anus wall while defecation and after defecation. I am using Pilex cream sometimes and recently i tried Anovate cream 2 to 3 times in total but no resolve or improvement in the pain, now i am in fear that if i go for a bowl moment the pain will increase. It started when i was around 17 years old due to constipation and hard stool then i got in the habit of holding the urge and the fear of pain/blood while forcing the stool, but then i started inserting the finger for bowl moment, along with isabgol or some laxetive churna. Now most of the time i don't feel my bowl moment like most people feel bit cramp while the process of emptying the bowl and everything happens naturally. So i still have my bowl moment with inserting finger, i know that i have to operate for the same but my worry is i don't feel bowl moment or have a bowl moment without the process i told earlier and what will i do after operate, please help me with my current situation for pain and swelling and with my query of the operate and the future.

Answered by Dr. Dr.P.Ratnakar Kini (2 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

You have Grade III-IV piles and a probable anal fissure.
How old are you?
Are you a diabetic ?
Do you have hypothyroidism?
Are you on any other medications?
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

Hi Doc,

Thanks for the reply, I am 37 and i don't have the latest tests done for diabetic and hypothyroidism. The last tests were done about nearly two years ago and it was negative, and i don't feel i have any of those as i don't have any other underline conditions those are related to both of the conditions you asked about. No sir i am not on any kind of medications, i am allergic to Analgesic drugs though(Like Asprin). Please suggest any medications/ointment for the pain relief and to stable the condition. Because i can't get operated for the same for about six months or so because of my financial condition.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Answered by Dr. Dr.P.Ratnakar Kini (8 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for the additional information.
You have chronic constipation and its complications in the form of piles and a probable fissure.
You need to undergo a few tests to plan treatment.

1. A digital rectal examination to examine the anal area
2. Anoproctoscopy to look in to the rectum for any solitary rectal ulcer as you have been doing digital evacuation
3. Colon transit study to see whether you have slow transit or normal transit constipation
4. Ano rectal manometry to assess the reflexes ( as you have mentioned you do not feel the urge ) and also to see whether the anal sphincters are working in the right way.
You have to consult a Gastroenterologist for these tests.

Meanwhile you can do the following for relief-
1. High fiber diet- Include lot of vegetables, fruits, prunes etc.
2. Drink lot of fluids
3. Do sitz bath for 10 minutes twice a day
4. Continue applying anovate at the anal verge after sitz bath
5. Take fiber supplements - Cremadiet Duo - two scoops in 250 of water at bedtime
6. Take Pruvict 2 mg once in the night
7. Increase your physical activity - at least 30 minutes of brisk walking

Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

Hi Doc,

Thanks for the detailed guidelines, could you please let me know the average cost of all the tests you mentioned, thanks in advance.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Hi Doc,

Thanks for the detailed guidelines, could you please let me know the average cost of all the tests you mentioned, thanks in advance.

Answered by Dr. Dr.P.Ratnakar Kini (8 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Around 7k to 8k INR.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Around 7k to 8k INR.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr.P.Ratnakar Kini (28 minutes later)

Thank you so much doctor, just one last question regarding the future life. If i go for an operate and knowing my condition what do you think will i be able to go for bowl moment like a normal person or not, and are there any kind of complications with the treatment/operation, hope you will understand my situation i am bit worried wasted and too long to talk about my issue and i want to live like a normal person.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Answered by Dr. Dr.P.Ratnakar Kini (12 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
You can lead a normal life.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
You can lead a normal life.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (5 days later)

Hi Doctor thanks for the reply, can you please suggest some other ointment as the swelling is not going away with anovate.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Hi Doctor thanks for the reply, can you please suggest some other ointment as the swelling is not going away with anovate.

Answered by Dr. Dr.P.Ratnakar Kini (6 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
It has to be examined by a doctor.
Till then you can apply proctosedyl and take fiber supplements and pruvict as suggested earlier.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
It has to be examined by a doctor.
Till then you can apply proctosedyl and take fiber supplements and pruvict as suggested earlier.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr.P.Ratnakar Kini (3 days later)

Thanks for the reply sir can you please provide me the prescription for all the things you suggested.

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Thanks for the reply sir can you please provide me the prescription for all the things you suggested.

Answered by Dr. Dr.P.Ratnakar Kini (2 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Prescription option is not available on this website.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Prescription option is not available on this website.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (1 hour later)

Hi Sir, If its possible can you sent it to YYYY@YYYY

Follow up: Dr. Dr.P.Ratnakar Kini (0 minute later)

Hi Sir, If its possible can you sent it to YYYY@YYYY

Answered by Dr. Dr.P.Ratnakar Kini (5 hours later)

Brief Answer:
Not legally allowed also

Detailed Answer:
Hi,
Giving a prescription without personally seeing the patient is not legally allowed also.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Dr.P.Ratnakar Kini (0 minute later)

Brief Answer:
Not legally allowed also

Detailed Answer:
Hi,
Giving a prescription without personally seeing the patient is not legally allowed also.
Regards,
Dr.R.K.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar