Brief Answer:
further necessary suggestion

Detailed Answer:
Dear
Thanks for contacting the Ayurveda section of [A]YUSH and after reviewing your case history I'm of the following opinion:

1. As piles are of grade 1 thus they can be well managed with the dietary regime, lifestyle management, and medicine.

2. As there is history of anal fissure in the past and I doesn't have any direct interaction [physical examination] thus it is mandatory to check with a local general surgeon or Ayurveda Physician [Shalya chikitsak]

3. Take fresh fruits and vegetables, avoid milk and milk products in the diet, an excess of tea, coffee, tobacco, alcohol and carbonated beverages.
ii. eat slowly, avoid haste-irregular eating and sweet/heavy food which are difficult to digest and cause indigestion.
iii. take less of strong spices (ginger, garlic), oily-fried-fatty food and flatus producing foods (peas, beans, dals).
iv. take old rice, bottle gourd, moong dal XXXXXXX marich, pomegranate, XXXXXXX hot water, adequate rest, and sleep.

v. butter milk [takra] is called as the Nector for humans and is widely used in piles
vi. Trifla: take 3 gm with lukewarm water at bed time
vii. Expile, pathyarishta,Immune-3, Neutraaci for the treatment of grade 1 pile is extremely beneficial [I can courier you the medicine along with other necessary medicine[s] since they are prepared by my pharmacy and won't be available

vii. In Diet take: elephant yam, papaya, butter milk, pistachio, almonds, pear, old rice, milk, crystallized sugar, raw radish and avoid tea,coffee,garlic,onion,fish,hot spices, sitting for long hours and avoid constipation by taking fibre rich diet and consuming plenty of fluids/water.

4.
- 1 glass lukewarm water every morning and night.
- 4tsf sugar+ 4tsf bitter gourd juice and drink for 1 month
- 3 pinches dried ginger+ 2 cup butter milk, drink after lunch and dinner for 1 month OR
- eat 2 tsf plain white butter + 1 tsf sesame powder before lunch and dinner and drink 2 cup butter milk + 3-4 pinches of black salt after lunch and dinner. [you can try any one of the following]

PS: .if job demands sitting, make sure you get up every half an hour to relax for 5 minutes and then sit back, make a sponge cushion for your chair

. Again piles are due to low digestive fire and taking amla & aloe vera juice will help in cleansing the liver to speed up the metabolism.
. Do not strain while passing stool, and use warm water or wet toilet paper but without perfume or alcohol(without soap) to clean your anus after each motion.
. Avoid cold/tap/jet (western seat) water.

Dr. Munish Sood
Consultant Physician
Naimittika

direct online link: bit.ly/drmunishsood

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