Dear XXXXXX

Thanks for contacting XXXXXXX and Ayurveda with your problem, and on observing your history I have come up with following suggestions,concerns and preventive line of treatment.

1. bleeding from anus after passing stool could be from swollen blood vessel (piles/hemorrhoids) or due to tear in the anus (fissure), hoping you have checked with your health care provider there,if not make an appointment with general surgeon at your place i.e Maharashtra.
2. because bleeding is also associated,you might have to undergo tumor marker test,for any bowel pathology (unless proved otherwise)
3. you have not told/specified about the COLOR of stool, whether it is bright red or dark,which can give us slight idea about the origin of bleeding in the digestive tract.
4. hurrying to toilet after meals can be a normal reflex unless there is hyper motility of digestive tract commonly called as IBS (irritable bowel syndrome), seeking an opinion of Gastro enterologist for the same can be helpful and useful, who can also rule out any food allergy or lactose intolerance.
5. you have not provided with any reports (if done any) nor about any addictions like smoking,alcohol, coffee consumption or any stress.
6. discharge of stool while passing gas could be possible FECAL INCONTINENCE which can be due to diabetes, multiple sclerosis,any injury to anal sphincter,chronic constipation all of which can result in weakening of rectum muscles.
7. because stool is foul smelling it is strongly recommended that you should see a doctor specialized in Gastroenterology for any pancreatic insufficiency, malabsorption, celiac disease or intestinal infection.
8. Clinical treatment will depend upon the diagnosis, preventive care can be suggested:
. take high fibre diet,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.
. for itching/pain you can go for "Sitz bath" i.e. soak your anus in bath tub filled with hot water for 10-15 minutes 2 or 3 times a day, if you experience any anal spasm then you can opt for alternate hot and cold bath every 5 minutes for half an hour.
. for bleeding take coconut water from 1 coconut after adding 2 spoons of sugar in it.
. take fried cumin seeds 500mg,fried asafetida (hing) 125mg, XXXXXXX parpati 500mg, mix them and take with honey three times a day.
. in your case 'psyco somatic' treatment is must, thus tranquility of mind is must, thus XXXXXXX drugs are useful.
. Trifla because of its high nutritional-detoxification-Shodhan and cleansing value is very helpful in treating your present complaints.

Please revert back with your concerns, and having an appointment/consultation with Gastroenterologist will surely help pacify you with your symptoms.

Dr.Munish Sood
Consultant & Physician
Naimittika Clinic

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Thanks for the concerns raised and describe.

1.because examination and consultation was done by Surgeon and Gastro enterologist, all the said differential diagnosis stand nullified,however for your clarification they are described below:
2.because bleeding was there in stool,so it was said “associated”…and also because site of bleeding was unknown it was postulated to undergo “tumor marker” i.e. test for any bowel malignancy (cancer) but because it “proved otherwise” to be XXXXXXX piles/proctitis hence the said ‘terms’ held no significance.
3.As told by you:the color of stool is RED i.e. cause and site is lower rectum and not upper Gastro intestinal tract (otherwise dark blood in color) but occult blood is positive requires re-evaluation.
4.Going by your reports it suggest:
i.green color stool: frequent and rapid running to toilet to empty bowels can result in rapid passage of unaltered BILE and hence green color of stool.
ii.Occult blood: i.e. which is detected chemically,were you taking any iron preparation or pain killers prior to test, and because it is not due to any Worm infestations as suggested by negative reports,so to diagnose the site of blood loss: sigmoidoscopy,colonoscopy or barium enema should be followed by upper G.I. endoscopy. (unless proved otherwise)
5.because you suffered from constipation from long time,this condition might have resulted in weakened rectal muscles and anal sphincters,which normally prevent passage of feces coming out while passing gas,resulting in FECAL INCONTINENCE i.e. unable to withhold feces.
6.As suggested by the Gastro enterologist IBS/IBD, celiac disease is collective name given to conditions associated with Intestine/Bowel disorder.
7. Along with said medicines for piles please add trifla guggulu 2 tab twice a day with Trifla Decoction or cow’s urine after meals and jatyadi tail for lubricating the XXXXXXX piles.
8. Along with it preventive aspect can be followed: of your choice
. 1 glass lukewarm water every morning and night.
. to stop bleeding:coconut water from 1 coconut and add 2 table spoon full (tsf) sugar and drink.
. drink 1 cup potato juice daily for 1 month.
. 4tsf sugar+ 4tsf bitter gourd (करेला) juice and drink for 1 month
.3 pinches (चुटकी) dried ginger (सौंठ) + 2 cup butter milk (लस्सी), drink after lunch and dinner for 1 month
. eat 2 tsf plain white butter (मक्खन) + 1 tsf sesame (तिल चूर्ण) powder before lunch and dinner and drink 2 cup butter milk + 3-4 pinches of black salt (काला नमक) after lunch and dinner
. take: elephant yam (जिमीकंद), papaya (पपीता), butter milk (लस्सी) pistachio (पिस्ता) almonds(बादाम) pear (नाशपाती) XXXXXXX (सेब) old rice, milk (दूध) crystallized sugar (मिश्री) raw radish (कच्ची मूली) and avoid tea-coffee,garlic,onion,fish,hot spices, sitting for long hours
9.Because black pepper has carminative properties, it reduces intestinal gas, and although it is spicy but only fraction bit as compared to others so can be safely taken.
10.There is an old saying “rice,wine, and wood improve in qualities when they get old, and old rice means which has been stored in unpounded/unpolished form for 1-2 years,bottle gourd is (लौकी/घिया)
11. XXXXXXX parpati is Ayurveda medicine in powdered form and suitable for people suffering from loose stool (IBS/IBD), take hing and jeera in dose recommended above and fry in ghee and take XXXXXXX parpati powder in dose prescribed,mix them well and take with honey.
12.     Psycho: (mind= मन) and somatic (body= शारीर), IBS is one example of psycho somatic disease in which simultaneous treatment of mind has to be done to achieve better results, XXXXXXX drugs are called as nootropics i.e. which boost intellectual functioning without unwanted side effects.
13.     Occult blood needs re evaluation by Gastro enterologist.

Dr.Munish Sood
Consultant & Physician
Naimittika.

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1.Because it is rectal bleeding i.e.of (lower Gastro intestinal), surgeon is correct.
2.To be on the safer side just go for CEA (carcinoma specific antigen) test and you will be worry free.
3.Re-evaluation of occult blood:
i.take 3 days high fiber diet and meat free diet,do not take vitamin C, avoid pain killers,medicinal iron,tooth brushing for three days and take the test for occult blood.
4.Bile is the fluid which is (yellow green) and while moving in your Gastro intestinal tract,changes from green to brown,but in cases of diarrhea where food is quickly moving out of the large intestine, bile doesn't have time to break down completely, thus green color is there in stool,it is normal
5.To strength the rectal muscle you can go for Kegel exercises by consulting your surgeon on how to do them properly,in addition avoid coffee,dairy foods,and add fiber XXXXXXX diet: XXXXXXX (rice, wheat,corn,oat), sunflower seeds,beans,nuts,avocados, Peas,Apples,Almonds,Pear
6.     –
7.     Only 1 medicine is prescribed along with current medication, and it can be taken with trifla Decoction if cow’s urine is not available,moreover if inserting is painful you can avoid the external application.
8.Right,you have the choice.
a.‘BOTTLE’ gourd and not ‘BITTER’ is prescribed, bitter is करेला.
b. you can take butter milk with breakfast and in evening around 6 PM, buttermilk is not only the best regimen but also the best medicine,because you say that you cannot take it after meals due to tummy gets too full,take before or with meals
c. elephant yam is ((जिमीकंद) which is known by other name as सूरण कंद,जमीन कंद, मदन मस्त check with your local vendor.
d. 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.
9.-
10. if old rice is not available,even then the one you are taking is good.
11. ghee and honey which is available can be taken for the said purpose XXXXXXX parpati is beneficial for you.
12. मण्डूकपर्णी,आमला,ज्योतिषमति, शंखपुष्पी,अश्वगंधा,शतावरी,वचा,ब्राह्मी,यष्टिमधु ,जटामांसी, are some of the best ‘medhya’ drugs you can choose singly or in compound form after consulting your Physician there.
13. if you are doing sex/masturbation frequently this results in muscles of the abdomen to be extra sensitive with very little time to relax resulting in heaviness,cramps,do meditation,Yoga to control your sexual urges and to increase mental strength.

Thanks for the concerns raised,
Dr.Munish Sood
Naimittika

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Dear RaviShankar

1.This problem is curable with medicine, just keep simple things in mind:
i.Avoid constipation (main reason of getting piles), take fiber XXXXXXX diet,drink plenty of water (liquids).
ii.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).
iii.For sitz bath,you can get one from a medical store or pharmacy- which fits over the toilet,in that way you can have the benefits of Sitz Bath
2.Yes,you can continue with the medications you are taking,Jatyadi tail is not to be consumed BUT applied externally for lubrication, around the anal region (also helps in relieving the associated itching)
3.The said drugs nagkesar and nagarmotha both are कषाय (Astringent) in रस (taste),thus helps in Abdominal disorders,control bleeding.
4.(A)Udumbar due to its कषाय रस and प्रभाव (impact) acts as anti diarrheal, coolant, anti inflammatory,analgesic.
5.Grahani kapat ras and other two will take care of IBS, indigestion with fullness of tummy
6.Just type elephant yam on Google and see the image(s) for further clarification.
7.Hard erection in morning regardless of season is NORMAL for every male (keep in mind)

Thanks for your feedback and wishing you best of wishes and get well soon, revert back for any further clarifications

Dr.Munish Sood
Naimittika

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Hi,

1.This is also known by other terms like morning tent/ morning wood, and occurs in males due to :

i.Increased testosterone secretion in morning.

ii.If one drink lots of liquids (tea,coffee,water), before going to bed, so in morning (during sleep) to hold the urine the person gets ‘hard rock erection’ which means you have to empty your bladder.

iiiThis is also the time when everyone is under REM (rapid eye movement)sleep i.e. the stage in which one dreams and getting “erection” is part and parcel of this stage along with paralysis of muscle (which is the reason we are unable to catch someone or run away from danger during sleep) so a person get 4-5 times the erection during this sleep which lasts for 7-8 hours,and if you or someone wake up in the middle of night,morning, erection is there.

iv.More the erection,healthier and harder the future erections,erection is vital for the health of penis ,so enjoy your erection and remember if you continuously take it as negative thought,this will get imprint into the brain and next time when you want an erection,you might not get one, do not masturbate to make it go away.

v.Remember not to take too much liquids after 6 PM and make sure to empty your bladder before retiring to bed,condition is psychological, (pain/cramps could be due to contraction of nerve attached to the testicles in which blood pressure increases during erection).

Dr.Munish Sood
Naimittika.

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Hi,

1.This is a vicious cycle: i.e when piles develops one is afraid to pass stool with fear of pain and bleeding resulting in constipation and due to constipation he has to strain hard to pass stool resulting in piles and the cycle continues, moreover IBS is characterized by constipation/diarrhea which further aggravates the problem, thus in Ayurveda we say that Piles-IBS-Diarrhea are inter related with each other and if one subsides other will start regressing itself, so if the prescribed regimen is followed , from 4 to 6 weeks improvement is seen.

2.-
3. Erection results in increase blood supply to the penis, so one will have several erections at night to keep the penis healthy. If you get erection without any cause, simple term is ‘spontaneous erection”, by this means that in future also you can last longer in sexual intercourse if presently you get hard and healthy erection, by harder it is meant that penile erection will sustain more and you will be less liable for ED (physiological erectile dysfunction).

4.–
5. Remember penis shy under pressure, so if you try to think to perform better erection goes away, so idea is to give more time to foreplay, if it is a matter of embarrassment try following tips:
- In morning wake up before others and go for a walk (to distract yourself) then no one can see you, or
- When in bed if erection is there try cover it with some magazine or book over your lap,
- If standing: remember erection makes penis go upwards (so fix your penis with underwear) so erection is not visible or if sitting just cross your legs so that erection comes in between the legs, because you only think that masturbating is the only way to relief yourself or to calm down, your brain has programmed itself in that way…try options suggested above and distract your mind from masturbating.

6.That is what male brain is programmed to get aroused with visual stimulation (live or in dreams), which give rise to so called night fall or wet dreams in man, this is the way by which body gets rid itself of sexual urges. Not me every healthy male get morning erection and it is absolutely NORMAL, (NPT-Nocturnal Penile Tumescence), erection is either due to collection of urine and if situation is else, just distract my mind and erection subsides, if still it persists think of something sad or worrisome moment., if someone sees the erection either he must know the natural phenomenon or Ignorance (lack of education, which is common).

7. If too much liquid is problem, let it subside by itself: taught and accept, waking up with an erection is completely normal.

8. If food is taken, blood is required for stomach and intestine for food absorption and if warm bath is taken afterwards the blood will be directed towards the skin, reducing blood flow to the digestive tract thereby resulting in Indigestion or abdominal discomfort.

Buttermilk is to be taken after meals and with salt. (REMEMBER: buttermilk after meals, ghee after sexual intercourse and milk at the end of day and water at the end of night.

Dr.Munish Sood
Naimittika.

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Hello Mr. XXXXXXX

1.If the problem keep coming back, what was the degree of piles told by the surgeon (from 1 degree to 4 degree)
.If bleeding is recurrent then take gond katira,(Tragacanth gum) 50gm and make it into fine powder, take this powder everyday 6 gm in 125 gm curd in morning after breakfast. (you can check Google for better identification of the medicine)
.Whenever you go to toilet, while urinating collect the urine in hand or some mug and wash your Anus with your urine, although looks bit awkward but is a very good preventive remedy against piles.
2. Erection occurs when blood flow to penis is increased,so if there is/are erections that means blood flow to this area is increased and because blood is related with carrying nutrition and oxygen (apart from other functions), it is healthy for penis. If you think erection doesn't help longer in sex,try giving maximum time to foreplay,because you are not suffering from any sexual dysfunction,neither counseling nor any other measures to develop ejaculatory control is necessary for you,Masturbation is a physiological and totally harmless act,you can reduce the sensation of glans by wearing a condom
3. If you cannot wake up in morning,you have to reset your body clock,and only you can do it,don’t expect from others,and if your mother shouts only because you give her the reason to do so.
4.Prefer khakis pants and loose shirts and make sure shirt is/are long enough to go beyond your waist and don’t tuck it under the pants,let it remain outside. Or (sweat shirts is another idea).
5.take butter milk after bath,HURRY/WORRY leads to IBD and again as described previously vicious cycle operates (reason it keep coming back)
6. In Ayurveda it is written that taking buttermilk with salt help cure indigestion (root cause of your problems),taking ghee after sex nourishes the tissues exhausted during the act and taking milk at night revitalizes the person from daylong fatigue.

Dr.Munish Sood
Naimittika.

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1.Alum (fitkari) though helps in arresting bleeding but is not what is mentioned for you, it is a raisin collected from stems,dried and sold at local ‘kirana’ store or Walmart shops.

2. Only Before going for stool,collect in a mug and then wash your anus, this way it is easy, 95% of urine is water, 2.5% is urea and 2.5% is a mixture of salts and other minerals…so irritation is negligible.

Dr.Munish Sood
Naimittika

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