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External piles, swelling, pain. Pilex cream, aloe vera gel not effective. Advise?

Hi Sir, I am 41 years. Weight is 74 kg, height is 5ft 5 inch. Last one week i am suffering from external piles (no blood) pain. It has swollen (some 3 in number) and swelling is not reducing. I have used Pilex cream and aloe vera gel. Not much relief. Any thing I can do to reduce the swelling and pain. Before also I have experienced this but once I used to control my diet, it used to reduce in 2-3 days. But this time its almost 6 days and i am in grave pain. Please help...
Asked On : Mon, 29 Apr 2013
Answers:  4 Views:  276
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General & Family Physician 's  Response
You are suffering from external piles, 3 nos., not reducing for the last 1 wk. Even after applying Pilex cream and aloe vera gel you are not relived. You had similar episode previously, which was relived by controlling the diet.
Piles usually comes in 3-7-11 o' clock position. Piles may occur either one, two or in all 3 positions.
As you said it is external piles which is not retracting. Your problem can't be managed fully by medical means. Temporarily you get some relief by medicines like laxative, pilex cream, diet, anti amoebic and sleeping with foot end elevated. But now what you need is surgical removal of piles. Do it as early as possible.
Best wishes
Answered: Mon, 29 Apr 2013
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General & Family Physician Dr. Nirmala P's  Response
Hi, thanks for asking in Healthcare Magic.

Creams, ointments and suppositories available for external piles can only relieve the symptoms and will not cure the condition. Diet forms a major role in the management of piles. Fiber rich diet, fruits, whole grains and plenty of fluids will all help to soften the stool and prevent straining in stools thereby preventing piles formation.

External piles causing severe pain could be due to thrombosis of the piles. Since you say that diet has not helped this time, it could be due to thrombosed piles. You should consult a surgeon if the pain is severe as it should be drained immediately under local anesthesia.

Olive oil is an emollient and local application of olive oil has been found to reduce piles. You can use it in future if piles form again. Branding is a method where a tight elastic band is placed around the base of piles to cut off the blood supply and makes it to fall within 7 days is also helpful to treat external piles.

I hope this is useful to you.
Answered: Mon, 29 Apr 2013
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General Surgeon Dr. Grzegorz Stanko's  Response

Thank you for the query.

First of all you need to know that no diet or medicines wont make your hemorrhoids to disappear. It can become less painful or less visible but wont disappear.
The only permanent solution is a surgical removal of them.
To make your symptoms go away I suggest you to try such treatment:
- avoid constipation (increase fiber rich products and mineral water intake)
- do not push hard on stool
- wash your anus after every stool
- have sitz baths with Quercus Cortex twice a day
- use OTC suppositories for hemorrhoids

Such treatment should give some relief in a week or so. However for permanent cure you should visit general surgeon.

Hope this will help.
Answered: Tue, 30 Apr 2013
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Orthopaedic Surgeon Dr. Sunil Kumar Srivastava's  Response
After defecation sit in Warm water in a tub with(sitz bath) twice a day atleast for 15 minutes each, and then apply Proctodesyl ointment which should be inserteted in anal region as well.Take Ibuprofen 400 mg three times a day after meals for 5 days and along with it take antibiotic coverage Cephalexin 500 mg 8 hourly for 5 days
Normally this regime will help
Answered: Mon, 29 Apr 2013
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Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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