Brief Answer:
Give further details.

Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
Surely I will tell you the best possible treatment allowable on a virtual world (internet).
To recapitulate: Male/23 - suffering from piles since 2 years - does not want surgery - wants to know the best treatment.

Before I can tell the exact treatment please tell me a few details so that I can assist you the best.
- What are your complaints?
- Any pain?
- Any bleeding?
- Do you have constipation/hard stools?
- Any other associated medical problems like diabetes, hypertension, any problem related to abdomen and passing of stools?
- What treatment have you tried till now as it is since 2 years that you are suffering?
- Most important : Have you been examined by a General Surgeon to see exact diagnosis; if piles are present the grades of piles like I or II or III, prolapse and all?

Answers to all these questions will give me exact diagnosis so that I can tell you the best.
Please write back.

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Brief Answer:
Please follow as advised .

Detailed Answer:
Hi.
Thanks for your feedback of having pain, constipation and hard stools sometimes and used pilex and pilgo.

If the pain is there there is more chances of that you may be suffering from a anal fissure and not the piles.

I would advise you the following: please read carefully, understand each point and follow strictly. It is you who have to take a proper care and treatment:

You can try the following method of treatment and you may NOT need surgery.
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation or any problem related to gastrointestinal system.
Laxative for softening the stool- never allow the dose too much to cause liquid stools. You can try Liquid Cremaffin plus 2 teaspoonfull to be taken at bedtime (night only).
Sitz bath- sitting in a tub with warm water. This is the most and very important- to be done just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5 day course of an antibiotic and Metronidazole (You need a prescription of a local Doctor) as I can not give a prescription on internet.
Also take probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.

Continue this for 3 weeks and most probably you may not need surgery.
If the results are positive you have to continue doing all this and take proper care.

Per-rectal and proctoscopy examination by a General Surgeon to get the exact cause/causes is also very important step. Get this done and give me feedback of the diagnosis told and the effects of the treatment I have suggested.

I hope this answer helps you.

...
http://bit.ly/askdrtchandrakant

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