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Piles, fistula, has had indigestion. Explain the treatment details? - Online Doctor Chats

Date : 30-May-2013
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1718 Questions
Doctor:How can I help you?
User: Good morning
User:My dad is suffering from Piles or pistula
User:i just wanted to know the dignosys and treatement details
Doctor:Piles or hemorrhoids and fistula are localised pathology of the anal cavity.
Doctor:The former (piles) occur due to engorgement of veins around the anal region.
Doctor:The distended veins cause pain, difficulty while passing stool as well as bleeding.
Doctor:Fistula on the other had is a tear in the mucosal linning of the anus.
Doctor:The symptoms here is similar to piles.
Doctor:The conditions can be differentiated by per rectal examination and proctoscopy - visualising the anal region with a scope.
User:since he had indisation problem since chieldwood days
Doctor:Treatment of both the condition is by means of conservative treatment and surgery.
Doctor:Both the conditions can be chronic recurring problem.
Doctor:Unless a per rectal examination or proctoscopy is done
User:and he managed with "Kayamchurna" for all these days
Doctor:it is very hard to differentiate among both the condition.
Doctor:Sometimes patient complain of feeling of mass lower down in the anal opening.
User:no he dont have that
Doctor:If your father complaints of any such mass along with his other symptoms, then it is likely that we are dealing with piles.
Doctor:But as I said earlier, we need to confirm it by per rectal examination or proctoscopy.
Doctor:Coming to the treatment part,
User:he says that recently there is a puss formition in the anus
Doctor:Presence of pus around the anal region suggest
User:ok go ahead
Doctor:1. Fistula has got infected
Doctor:2. There is infection around hemorrhoids (piles)
Doctor:3. The pus can be due to some other infective cause such as infected pilonidal cyst, localised abscess, infected folliculitis and so on.
Doctor:We may be able to confirm the diagnosis only by examination.
User:ok, sir what is the first step and what scanning or testing to be done
Doctor:Let me put across the steps you can follow.
User:that would be great sir,
Doctor:1. Make him drink plenty of water and take lot of fibres in diet. This will prevent the problem from worsening.
Doctor:2. XXXXXXX warm water sit bath will relieve any inflammation that is happening there.
Doctor:* siting in a tub with XXXXXXX warm water will also help in reducing pain and swelling if any.
Doctor:3. Topical antibiotic creams such as mupirocin 1 or 2% cream which are available over the counter can be applied to the external lesions.
Doctor:Do not use this cream inside the anal cavity.
Doctor:Only if any lesions are present externally away from the anus, you may use them.
Doctor:4. If he has history of diabetes, his current sugar status needs to be checked.
Doctor:Blood sugar test is important then.
Doctor:5. Laxative syrups such as Syp Lactulose 20-30ml taken at night for 1-2 weeks will help immensely.
Doctor:6. Last but important is to plan a visit to your doctor, preferably a surgeon for direct examination, proctoscopy and per rectal examination.
Doctor:Based on the clinical appearance and the size/grade of the lesion surgical treatment if any can be planned.
Doctor:Have you followed what I suggested?
Doctor:Do you have any other query?
User:He did all this with the direction of local doctor accept the 6th point
Doctor:If the above measures have failed to give him any relief, then he might need to undergo some procedures or minor surgery.
Doctor:In addition he may need some oral antibiotics based on studies on pus samples.
User:ok please suggest good doctor so that i can get it checked
Doctor:So consulting a surgeon would be the best approach to handle this circumstances.
Doctor:You can consult any surgeon near by your locality.
Doctor:Alternatively surgical gastroenterologist
User:would you be able to give the details ?
User:even the examination can be done there (rectal examination or proctoscopy)
User:do you suggest me to go after the rectal examination or proctoscopy?
User:if yes where can i get it done
Doctor:Per rectal examination is done as a part of clinical examination
Doctor:Proctoscopy will be done by proctologist or surgical gastroenterologist.
Doctor:The latter gives more information as there is direct visual examination of the affected region.
Doctor:If the problem is not an external abscess or infected follicles or pilonidal cysts,
Doctor:then this needs proctoscopic examination.
Doctor:As you visit the doctor, he / she will initially perform per rectal examination and then order for proctoscopic analysis.
Doctor:your doctor should take care of it.
Doctor:So don't worry.
Doctor:Is there any other query?
User:what would be the approximate cost of this tests
Doctor:The test can be performed at the doctors office
Doctor:and most likely should be included in the doctor's fees.
Doctor:You may be charged an additional 200 - 1000 INR depending on the institute / doctor performing it.
User:sorry if i had asked you not relevant questions and thank you so much Doctor
Doctor:I am not sure of the price as it varies, but this is how most likely your father would be managed.
Doctor:Do consult a local surgeon or one of the specialist at those hospitals or any other piles/fistula clinic near your locality.
Doctor:Things would be much clear and easier to manage once the cause is found.
Doctor:Hope it is clear to you.
Doctor:Do you have any other query?
User:No doctor and thank you for info,
Doctor:You are welcome.
User:have a nice day!
Doctor:Thanks for consulting me.
Doctor:Bye for now.
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