** A. 1. a discharging sinus/scar in the vicinity of the anus is always a fistula-in-ano, you should consult with a surgeon regarding fistulectomy. 2. Anal fistula mean there is an open track [which is communicating from exterior to interior], as a result healing won t be there despite any conservative line of treatment. 3. If surgical intervention is not done it will/may lead to multiple openings [fistula tracks] 4. you can incorporate following methods to alleviate the symptoms: . hot hip bath: sit in a tub of warm water for 10 minutes [2 times a day] . 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. . 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. . taking amla & aloe vera juice will help in cleansing the liver to speed up the metabolism. PS. prescription medicine for you are Trifla guggulu, abhyarishta, jatyadi tail,chitrakadi tail,navkarshik guggulu. B Since you have undergone bye pass [heart patient] thus keep following things in mind: . avoid sudden exertion e.g. climbing stairs in haste,moving furniture in house etc. . graded exercise in the form of walking but within the limits of tolerance. . fat free diet, use sunflower oil . strict control of hypertension,diabetes and hyperlipidemia, if present . elimination of known risk factor: smoking, over weight, mental strain