Brief Answer:
follow the advises.. maintain a healthy lifestyle..

Detailed Answer:
Hello XXXXXXX Welcome to HCM..

I've gone through your query and understand your concern..

Now, you've mentioned that you think you're having piles and fissure, can you clarify what made you think so ?

Also have you got yourself checked by any doctor for this yet ? (no , the 3 yr old visit isn't really suffice in this case)..

Please tell me what are the problems that your actually suffering from ?

Since when are you facing this problem and what actually relieves/worsens it ?

Please let me know these answers so that I can guide you better in a more specific way..

Awaiting your response..

Kind Regards

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Brief Answer:
You need to get examined by a General Surgeon thoroughly ..

Detailed Answer:
Hello XXXXXXX welcome back,

Thanks for following up..

Yes, it's the part of your colon which is coming out, clean your hand with anti-bacterial hand-wash and gently push it back in side..If you can't push it back gently, then don't apply further force and go to your nearest ER at the earliest where they'll do it..

Don't worry, it's not tumor, however it appears from your descriptions that the hemorrhoids(piles) is in advanced stage..

So you need to schedule an appointment with a General Surgeon/Proctologist to get yourself thoroughly checked as in advanced stage of hemorrhoids, there may be a need to get it surgically corrected, but it only depends on the findings after the physical examinations..

Remember not to strain at all during passing motion, you can take Syp Lactulose 15 ml Once Daily at bedtime for that..

Maintain good hydration by drinking a lot of water(3-3.5 ltr per day) to avoid any constipation..

Avoid spicy/oily foods and eat only home cooked meals..include a lot of fiber in diet(green leafy vegetables,whole grain foods etc.), all these will help you in the long run..

Let me know if there's any further doubts..

Take Care
Kind Regards

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