Brief Answer: Prophylactic Aspect Detailed Answer: Dear XXXX Thanks for contacting Ayurveda with your health concern. 1. You can start incorporating following Dietary Regime and Management: -take fresh fruits and vegetables,avoid milk and milk products in diet, excess of tea,coffee,tobacco,alcohol and carbonated beverages. - eat slowly,avoid haste-irregular eating and sweet/heavy food which are difficult to digest and cause indigestion. - take less of strong spices (ginger,garlic), oily-fried-fatty food and flatus producing foods (peas,beans,dals) - take old rice,bottle gourd,moong dal XXXXXXX marich, pomegranate,jaiphal,hot water, adequate rest and sleep. - take fried cumin seeds 500mg, fried asafetida (hing) 125mg, XXXXXXX parpati 500mg, mix them and take with honey three times a day. - 1 glass lukewarm water every morning and night. - drink 1 cup potato juice daily for 1 month. - 4tsf sugar+ 4tsf bitter gourd juice and drink for 1 month - take: elephant yam, papaya, butter milk, pistachio, almonds, pear, XXXXXXX old rice, milk, crystallized sugar, raw radish and avoid tea,coffee,garlic,onion,fish,hot spices, sitting for long hours. - Trifla because of its high nutritional-detoxification [Shodhan] and cleansing value is very helpful in treating your present complaints. [take 3 gm with XXXXXXX warm water at bed time] 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. . 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. PS. i. since knowing our limitations, Dietary Regime and Management has been provided from my side, but since you were examined by a surgeon [proctologist] who is in better position to explain the prognosis be in his regular guidance. ii. prescription medicine for you are Trifla guggulu, abhyarishta, jatyadi tail,chitrakadi tail,navkarshik guggulu. iii. 1. 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. 2. If surgical intervention is not done it will/may lead to multiple openings [fistula tracks] Dr. Munish Sood Consultant & Physician Naimittika Clinic

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