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Suggest Treatment For Acute Chronic Fissured Hemorrhoids
Question: i am suffering from acute chronic Fissured Hemorrhoids since last 8 months.
No bleeding but severe pain after defection, last for many hours.
now, Doctor advised STARR Surgery, am fearing the same.
Cant understand, what to do?
Anus opening gets tight in case complete defection is not achieved and painful.
On complete defection pain is minimal.
One Fissure at the opening, swells and pains, peanut size hemorrhoid.
Not protruding out, sometimes on pressure defection protrude and go back in.
Internal pain spreads to both hipps.
No bleeding but severe pain after defection, last for many hours.
now, Doctor advised STARR Surgery, am fearing the same.
Cant understand, what to do?
Anus opening gets tight in case complete defection is not achieved and painful.
On complete defection pain is minimal.
One Fissure at the opening, swells and pains, peanut size hemorrhoid.
Not protruding out, sometimes on pressure defection protrude and go back in.
Internal pain spreads to both hipps.
Brief Answer:
Instead go for something non invasive
Detailed Answer:
Hi
Thanks for writing in
What I understand from your information is that the hemorrhoids are around grade III
If you are scared of STARR I would suggest you go for something non invasive like Doppler guided hemorrhoidal artery ligation
This procedure is evidence based and has minimal postoperative pain
You can be back to work from the next morning
Hope this helps
Do write back in case of concern
Instead go for something non invasive
Detailed Answer:
Hi
Thanks for writing in
What I understand from your information is that the hemorrhoids are around grade III
If you are scared of STARR I would suggest you go for something non invasive like Doppler guided hemorrhoidal artery ligation
This procedure is evidence based and has minimal postoperative pain
You can be back to work from the next morning
Hope this helps
Do write back in case of concern
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanking you for the advice.
Yes, My hemorrhoids have been Graded III, '
Grade III by two surgeons while Grade II by another two surgeons.
Details:
January 29, 2014 :
Complaint: Pain in anal region with bleeding during defection
Diagnosis: 1 Piles, Fissure in Ano
Rx, Daflon, Proctosedyl Ointment, Ultracet SOS, Creanffn, Cardiolax
ON/OFF Symptoms remained
No Pain incase of smooth complete defection, Pain again incase of in-complete defection.
March 03, 2014 : Added Venex 300 (Diosmin)
April 14, 2014 : Added Domperidone
XXXXXXX 02, 2014 :
Complaint: Severe pain and burning
Diagnosis: 2 Small External Hemorrhoids with Fissure, 1 Internal Hemorrhoid
Not at the stage of operative advice.
Rx, Daflon, Fybogel, Lox2%, High Fibre Diet
July 21, 2014 :
Complaint: Severe Pain During Defection, Continuous Pain or Dis-comfort
Diagnosis: Acute Chronic Fissured Hemorrhoid at 7’o Clock with mixed HD at 3/ 11’ o Clock with anal spasm.
Rx, C.L.I.S (Centre for Laser & Interventional Surgery) to remove a fissured hemorrhoid, compromising a sphincter , followed with UHMS (Current Waves).
July 23, 2014 :
Complaint: Pain during & after defection, Incomplete Evacuation
Diagnosis: 2 Hemorrhoids with Fissure, sphincter tone 14
Rx, Anovate Ointment, High Fibre diet with POOF
Aug 21, 2014 :
Complaint: Pain Post defection (many hours), Incomplete Evacuation
Diagnosis: Piles and Fissures Grade III, further Investigation required.
Treatment options : BioFeedback or Stapler Haemorrhoidectomy for Piles
Or STARR Surgery
Tests- DEFECOGRAPHY and MANOMETRY
Rx, Constac, Sitcom (Euphorbia Prostrata Extract)
Reports: MANOMETRY – NORMAL, DEFECOGRAPHY- POSITIVE, Impression: Severe descent of the anorectal junction, Mild anterior and mild posterior rectocoeles with rectorectal intussception.
Advice: Correct constipation with STARR Surgery primary cause of hemorrhoid.
Scared: Part of intestine being removed, shortening of the track- consequences. Fissured hemorrhoids remain.
Appreciate your prompt advice.
Yes, My hemorrhoids have been Graded III, '
Grade III by two surgeons while Grade II by another two surgeons.
Details:
January 29, 2014 :
Complaint: Pain in anal region with bleeding during defection
Diagnosis: 1 Piles, Fissure in Ano
Rx, Daflon, Proctosedyl Ointment, Ultracet SOS, Creanffn, Cardiolax
ON/OFF Symptoms remained
No Pain incase of smooth complete defection, Pain again incase of in-complete defection.
March 03, 2014 : Added Venex 300 (Diosmin)
April 14, 2014 : Added Domperidone
XXXXXXX 02, 2014 :
Complaint: Severe pain and burning
Diagnosis: 2 Small External Hemorrhoids with Fissure, 1 Internal Hemorrhoid
Not at the stage of operative advice.
Rx, Daflon, Fybogel, Lox2%, High Fibre Diet
July 21, 2014 :
Complaint: Severe Pain During Defection, Continuous Pain or Dis-comfort
Diagnosis: Acute Chronic Fissured Hemorrhoid at 7’o Clock with mixed HD at 3/ 11’ o Clock with anal spasm.
Rx, C.L.I.S (Centre for Laser & Interventional Surgery) to remove a fissured hemorrhoid, compromising a sphincter , followed with UHMS (Current Waves).
July 23, 2014 :
Complaint: Pain during & after defection, Incomplete Evacuation
Diagnosis: 2 Hemorrhoids with Fissure, sphincter tone 14
Rx, Anovate Ointment, High Fibre diet with POOF
Aug 21, 2014 :
Complaint: Pain Post defection (many hours), Incomplete Evacuation
Diagnosis: Piles and Fissures Grade III, further Investigation required.
Treatment options : BioFeedback or Stapler Haemorrhoidectomy for Piles
Or STARR Surgery
Tests- DEFECOGRAPHY and MANOMETRY
Rx, Constac, Sitcom (Euphorbia Prostrata Extract)
Reports: MANOMETRY – NORMAL, DEFECOGRAPHY- POSITIVE, Impression: Severe descent of the anorectal junction, Mild anterior and mild posterior rectocoeles with rectorectal intussception.
Advice: Correct constipation with STARR Surgery primary cause of hemorrhoid.
Scared: Part of intestine being removed, shortening of the track- consequences. Fissured hemorrhoids remain.
Appreciate your prompt advice.
Brief Answer:
I would still try RAR
Detailed Answer:
Hi XXXX
I am impressed the way you have presented your history
It seems you are a medical person anyway people like you make our job easier
Considering the fact that you have grade III hemorrhoids and MR Defecogram shows a rectorectal intussception, With over a decade of experience with the procedure I would give rectoanal repair a fair chance in your age group
But if the same procedure in not available in your town then STARR is the next best option
Out of the way what is the biopsy report of the sessile polyp ?
Also if you can courier me the MR Defecogram DVD or if you can share it online, I would be in a better position to help
Hope this helps
Do write back in case have any doubts
Wishing you a healthy life ahead
I would still try RAR
Detailed Answer:
Hi XXXX
I am impressed the way you have presented your history
It seems you are a medical person anyway people like you make our job easier
Considering the fact that you have grade III hemorrhoids and MR Defecogram shows a rectorectal intussception, With over a decade of experience with the procedure I would give rectoanal repair a fair chance in your age group
But if the same procedure in not available in your town then STARR is the next best option
Out of the way what is the biopsy report of the sessile polyp ?
Also if you can courier me the MR Defecogram DVD or if you can share it online, I would be in a better position to help
Hope this helps
Do write back in case have any doubts
Wishing you a healthy life ahead
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Dear Doctor,
Great-full for your advice and support.
Thx for the compliment.
It's just that I am suffering, my job is to generate systematic reports, therefore attempted to convey in the best way I could.
Biopsy reports received today, on phone, yet to be collected is NEGATIVE.
"Mild Variation of
Lamina prepria shows chronic inflamation,
No eves envy of Malignancy"
Defecogram CD was not given to me,
However would attempt requesting the same at Inamdar Hospital, XXXXXXX
As described by the technician, the abnormality was not major
But slight, As felt by me on applying pressure to defecate the GEL, I felt
Only little spreading towards by Hips/ bumps, On inspecting the extract, feel about 15% remained inside. 30 mins post, I defected the remaining gel along with stool, my pain went away and felt so relieved. Doctor opinion'd the report is not as serious, could be attempted to be corrected with Biofeedback method, but advice STARR for guaranteed suction.
The visual of the slide also shows 15-20 % bulge.
I live in Mumbai( Navi Mumbai), originally from XXXXXXX so either places convenient for treatment.
I tried allopathy, diet management, Ayurvedic, Homeopathy - surprising could
Not achieve cure !!!
Awaiting your advice
Regards
XXXX
Great-full for your advice and support.
Thx for the compliment.
It's just that I am suffering, my job is to generate systematic reports, therefore attempted to convey in the best way I could.
Biopsy reports received today, on phone, yet to be collected is NEGATIVE.
"Mild Variation of
Lamina prepria shows chronic inflamation,
No eves envy of Malignancy"
Defecogram CD was not given to me,
However would attempt requesting the same at Inamdar Hospital, XXXXXXX
As described by the technician, the abnormality was not major
But slight, As felt by me on applying pressure to defecate the GEL, I felt
Only little spreading towards by Hips/ bumps, On inspecting the extract, feel about 15% remained inside. 30 mins post, I defected the remaining gel along with stool, my pain went away and felt so relieved. Doctor opinion'd the report is not as serious, could be attempted to be corrected with Biofeedback method, but advice STARR for guaranteed suction.
The visual of the slide also shows 15-20 % bulge.
I live in Mumbai( Navi Mumbai), originally from XXXXXXX so either places convenient for treatment.
I tried allopathy, diet management, Ayurvedic, Homeopathy - surprising could
Not achieve cure !!!
Awaiting your advice
Regards
XXXX
Brief Answer:
Biofeedback and RAR
Detailed Answer:
Hi XXXX
Thanks for writing in again
With passage of time I have generated a habit of interpreting personality from the XXXXXXX and organised hard disks, so the compliment came out spontaneously
Coming to your issue, I would suggest you try Biofeedback and RAR, try searching for the same in XXXXXXX or else.....
XXXXXXX is not far, I have not less than 100 patients in XXXXXXX
You can fly back the same day of surgery
Rectoanal repair is apparently non invasive
You may also google for the authenticity of the facts
Hope this helps
Regards
Biofeedback and RAR
Detailed Answer:
Hi XXXX
Thanks for writing in again
With passage of time I have generated a habit of interpreting personality from the XXXXXXX and organised hard disks, so the compliment came out spontaneously
Coming to your issue, I would suggest you try Biofeedback and RAR, try searching for the same in XXXXXXX or else.....
XXXXXXX is not far, I have not less than 100 patients in XXXXXXX
You can fly back the same day of surgery
Rectoanal repair is apparently non invasive
You may also google for the authenticity of the facts
Hope this helps
Regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Doctor,
But, How would this be corrected ?-
1. "Severe descent of the anorectal junction, Mild anterior and mild posterior rectocoeles with rectorectal intussception."
2. "Lamina prepria shows chronic Severe Inflammation" - Colonoscopy Report.
3. ODS- Obstructive Defection Syndrome.
4. Constipation
Then,
1. Internal Hemorrhoid
2. External Hemorrhoids & Fissures.
But, How would this be corrected ?-
1. "Severe descent of the anorectal junction, Mild anterior and mild posterior rectocoeles with rectorectal intussception."
2. "Lamina prepria shows chronic Severe Inflammation" - Colonoscopy Report.
3. ODS- Obstructive Defection Syndrome.
4. Constipation
Then,
1. Internal Hemorrhoid
2. External Hemorrhoids & Fissures.
Brief Answer:
Phase wise manner
Detailed Answer:
Hi XXXX
As I had mentioned earlier I would prefer going for a phase wise manner
1. Internal Hemorrhoid
2. External Hemorrhoids & Fissures.
Will be managed with calibrated dilatation and/or sphincterotomy clubbed with hemorrhoidal artery ligation
2. "Lamina prepria shows chronic Severe Inflammation" - Colonoscopy Report.
3. ODS- Obstructive Defection Syndrome.
4. Constipation
Will be managed medically and rectoanal repair
1. "Severe descent of the anorectal junction, Mild anterior and mild posterior rectocoeles with rectorectal intussception."
Will comment once I see the MR Defecogram
Hope this clears your doubts
Regards
Phase wise manner
Detailed Answer:
Hi XXXX
As I had mentioned earlier I would prefer going for a phase wise manner
1. Internal Hemorrhoid
2. External Hemorrhoids & Fissures.
Will be managed with calibrated dilatation and/or sphincterotomy clubbed with hemorrhoidal artery ligation
2. "Lamina prepria shows chronic Severe Inflammation" - Colonoscopy Report.
3. ODS- Obstructive Defection Syndrome.
4. Constipation
Will be managed medically and rectoanal repair
1. "Severe descent of the anorectal junction, Mild anterior and mild posterior rectocoeles with rectorectal intussception."
Will comment once I see the MR Defecogram
Hope this clears your doubts
Regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dear Doctor,
On your advice,
I would get my hemorrhoid and fissure treated, later find cure to the ODS.
Once more need your advice.
Found your profile, you are the best.
I may be prepared for Ayurveda Thread Treatment -
Kshara therapy, instead of RAR as it is stated to be 100% satisfactory results as compared to RAR with 89%.
Only if the pain during and post is manageable and tolerable.
No one seems to be commenting on the pain.
Do they also take support of Allopathy pain management meds?
What could be the ratio of pain in both the procedures (comparison)
On your advice,
I would get my hemorrhoid and fissure treated, later find cure to the ODS.
Once more need your advice.
Found your profile, you are the best.
I may be prepared for Ayurveda Thread Treatment -
Kshara therapy, instead of RAR as it is stated to be 100% satisfactory results as compared to RAR with 89%.
Only if the pain during and post is manageable and tolerable.
No one seems to be commenting on the pain.
Do they also take support of Allopathy pain management meds?
What could be the ratio of pain in both the procedures (comparison)
Brief Answer:
Can Not Comment On KS
Detailed Answer:
Hi
Thanks for writing in again
Just to inform you about my ethics, all these twenty seven years I have refrained from commenting on a procedure not related to my specialty
I can assure you of my skills but will never criticize any one else
When my patients argue on this issue I just tell them to have one experience and then get back to me
The pain in RAR as per the International multicentre study I had participated in was not more than 2-3 on VAS
KS I can not comment ask a patient who has undergone the same
Hope this helps
Do write back in case you need more clarification
Can Not Comment On KS
Detailed Answer:
Hi
Thanks for writing in again
Just to inform you about my ethics, all these twenty seven years I have refrained from commenting on a procedure not related to my specialty
I can assure you of my skills but will never criticize any one else
When my patients argue on this issue I just tell them to have one experience and then get back to me
The pain in RAR as per the International multicentre study I had participated in was not more than 2-3 on VAS
KS I can not comment ask a patient who has undergone the same
Hope this helps
Do write back in case you need more clarification
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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