Brief Answer:
He needs to observe prompt remedies for relief of the pain.

Detailed Answer:
Dr. Hanif warmly Welcomes you!

Thanks for consulting at my virtual clinic. I have carefully worked through your case, and I can realize your health worries. Being your physician, I assure you not to worry as I will take care all of your medical concerns.


Possibilities:-
Anal Fissure (Very consistent with this history. The pain in fissures isn't necessarily mandatory to stay only confined to the anus. It presents as he is feeling).
Hemorrhoids (less likely but may be).
Ulcerative colitis (very less likely).


Management:-
He seems to have anal fissure. It is a tear in the wall of anal mucosa and due to pain the muscles of the external anal sphincter becomes very tightly closed as a guarding reflex. Mostly patients avoid voiding feces due to pain.

The first step is to manage the pain and improve his bowel movements. The main issue in such a case is with the unbearable pain during the act of passing the stools and that is a reason for avoiding and holding feces and it leads to harder stools making the situation worse.


Remedies for pain:-
To relieve pain give him Ibuprofen orally and ProCort rectal cream to be applied with an applicator inside the anus.
Petroleum jelly will also be beneficial alongwith the above cream.
If stools are harder, say him to use Glycerine Suppositories for loosening it up and making the situation easy for him.

Ask him to use Sitz Bath 3 times a day to soothe and heal. It is actually a bath tub with XXXXXXX warm saline water in it dipping the hips when sitting in it. Most of the anal fissures heal up by themselves with these home remedies and the above cream and a very few needs surgical care or Botox injection.


Instructions:-
Give him upto 6 litres of water+other fluids.
Give Citrucel dietary fiber supplement with plenty of water.
Syrup Lactulose at night for stools to get soft.
Take more vegetables, fruits and salads in diet.
No beverages, caffeeinated drinks, energy drinks, refined foods, fried and junk foods and processed meat.
Take whole grains.

Hope I answered all of your health concerns . If you have further questions, feel free to contact me anytime. Always write my name in start of your question in future, and I will get back to you in no time. If satisfied, please give your generous 'five Star rating' and don't forget to 'Close the discussion'.

Have a wonderful time ahead.


Best Regards!
DR. HANIF
USA

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