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Suggest treatment for hemorrhoids

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
my sentinel piles looks as reddish small skin tag with swelling with severe pain during passing of stools and movement. presently i'm taking oral painkillers and laxative and anovate oint for last 15 days with mild relief
Posted Sat, 8 Mar 2014 in Constipation
Answered by Dr. Sudhir 22 minutes later
Brief Answer: In that case other treatment options can be tried. Detailed Answer: Thanks for query There are multiple ways of treating hemorrhoids depending on stage. The treatment can be either medication, nonsurgical procedure or surgical procedure. Medications------- One you have already tired.Local anesthetics temporarily relieve pain, burning, and itching by numbing the nerve endings. (Benzocaine 5% to 20% or Lidocaine 2% to 5%) Vasoconstrictors when applied to the anus, make the blood vessels become smaller, which may reduce swelling. Protectants (Aluminum hydroxide gel, Glycerin)prevent irritation of the perianal area by forming a physical barrier on the skin that prevents contact of the irritated skin with aggravating liquid or stool from the rectum. Astringents (calamine) cause coagulation (clumping) of proteins in the cells of the perianal skin or the lining of the anal canal. This action promotes dryness of the skin, which in turn helps relieve burning, itching, and pain. Analgesic products relieve pain, itching, and burning by depressing receptors on pain nerves. (Menthol 0.1% to 1.0% ) Corticosteroids reduce inflammation and can relieve itching, but their chronic use can cause permanent damage to the skin. They should not be used for more than short periods of a few days to two weeks. Nonsurgical procedures ----- Sclerotherapy: During sclerotherapy, a liquid (phenol or quinine urea) is injected into the base of the hemorrhoid. Inflammation sets in, and ultimately scarring takes place. Rubber band ligation: The principle of ligation with rubber bands is to encircle the base of the hemorrhoidal anal cushion with a tight rubber band. The tissue cut off by the rubber band dies and is replaced by an ulcer that heals with scarring. Heat coagulation: There are several treatments that use heat to kill hemorrhoidal tissue and promote inflammation and scarring, including bipolar diathermy, direct-current electrotherapy, and infrared photocoagulation. Cryotherapy: Cryotherapy uses cold temperatures to obliterate the veins and cause inflammation and scarring. It is more time consuming, associated with more post treatment pain, and is less effective than other treatments. Doppler ligation: The doctor can tie off (ligate) the artery under guidance of doppler. This causes the hemorrhoid to shrink. Surgical procedures----- Sphincterotomy. The internal portion of the anal sphincter is partially cut in an attempt to reduce the pressure of the sphincter within the anal canal. This is less commonly used as loss of sphincter control is its complication. Hemorrhoidectomy: Surgical removal of hemorrhoids (hemorrhoidectomy) usually is reserved for patients with third- or fourth-degree hemorrhoids. Postsurgical pain is a major problem with hemorrhoidectomy. Stapled hemorrhoidectomy: Its acomparetively new method and here the hemorrhoidal tissue is cut off using stapler. These are the various option one can choose among. On clinical examination the doctor can decide the stage of hemorrhoid and accordingly treatment can be proposed. Most case are very well treated with medication and no-surgical procedures. And surgical treatments can be considered only if they fail. Please ask if i have left any of your query unanswered or if there are any doubts.
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Follow-up: Suggest treatment for hemorrhoids 56 minutes later
Pls diagnose the degree of hemmorhoid shown in image? And if nitroglycerine oint will be helpful in reducing the swelling and pain?
Answered by Dr. Sudhir 7 minutes later
Brief Answer: Nitroglycerine ointment may relieve symptoms Detailed Answer: Nitroglycerine ointment may relieve symptoms but will not heal it completely.Your grade needs treatment either by non-surgical procedures or surgery. I have listed all options so that you can discuss them with your doctor.Medications are listed so that you can try them till you get procedure done. Regards.
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