Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
147 Doctors are Online

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 : 1777 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.
Question is related to
Diseases and Conditions
Medical Topics
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor