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    Suggest treatment for rectal pain

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Posted on Thu, 3 Aug 2017 in Abdominal Pain
Question: Hi Sir,

I had very hard stool 3 weeks back.After that I have pain on sides of anus but no blood.Then I started taking laxative and drinking more water.
My stools became normal and softer.But still I am feeling pain when I go to bowel on sides and pain will last for 1 hr so and it will disappear.
Sometimes I feel like itchy and pain when I sit also.

I am worried al lot and afraid of this.Could you please help me.


Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Proctoscopic examination of rectum should be done.

Detailed Answer:

Hello,
Thank you for choosing HealthcareMagic for your query.
I've gone through your details.
I am a Gastroenterologist and would be addressing your concerns.

As per your queries, answers are-

Many times due to regular constipation or overstraining while passing stools the mucosal layer in rectum get eroded and this breech in mucosa can cause all the problems you are having right now.
Continue taking syp. Lactulose 10-15ml once daily before going to bed. It is one of the most frequently used laxatives, tolerated very well by patients in long terms with minimal side effects. When stool passes easily over injured area its chances of healing increase by many folds.

-Secondly, use a combination containing contains Calcium Dobesilate, Hydrocortisone, Lignocaine, and Zinc Prepsration H cream(OTC).

Add Metamucil/Fybrogel to your regimen. It's a natural laxative containing husk. It absorbs water from the intestine and swells up making passage of stool easy and add bulk to stool.

However, if not relieved in a week time then we would go for digital rectal examination to look for hemorrhoid(Internal hemorrhoid never bleed) - Oral Calcium Dobesilate-Doxium therapy for 3 months would be started. Initially twice daily for 21 days followed by once daily for 10 weeks. Trials have shown that 3-month therapy can cause shrinkage of Hemorrhoids in almost 80% cases.

Feel free to ask further.

Thanks!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ramesh Kumar 22 minutes later
Hi Sir,

I am currently taking cremaffin lexative.
And using preparation H cream.
Will that helps?

I am afraid whether i require surgery or something?

And also afraid whether it leads to something else?

How long does it take to heal completely?

I am very very worried sir.Currently i leave in us.

Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 6 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hi again dear,
1)Yes they are almost the same and would be helfful.
2)In case its not just a normal breech and is a hemorrhoid noninvasive methods have to be used.

Brief idea about rme same-
As per protocol


As per the protocol intial stages of hemorrhoids are managed conservatively while surgery is done on later satges hemorrhoid.Stangong can be done pnlyvafter rectal examination of your canal.

Suggestion for conservative management are-

Apart from laxative and preperation H request your gastroenterologist to prescribe you with oral Calcium Dobesilate-Doxium therapy for 3 months. Initially twice daily for 21 days followed by once daily for 10 weeks. Trials have shown that 3-month therapy can cause shrinkage of Hemorrhoids in almost 60% cases.
However, if not relieved even after 3 months of aggressive therapy proceed for Rubber bands ligation- inexpensive and are easy to deploy. It's a daycare procedure usually done under local anesthesia. The success rate varies from about 70-80%..


Thanks



Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ramesh Kumar 1 hour later
Hi Sir,

Thanks for the response,

One more question.

So now its almost 3 weeks.Usually how long does it take to heal the fissure?

Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 6 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hello again XXXXXXX
With proper therapy it should show improvement in a week or so.

Thanks,
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Ramesh Kumar 4 hours later
Hi Sir,


Looks like top of bowel is always hard and after that it is softer.So What shouldi do for that?


Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Follow up.

Detailed Answer:
Hi XXXXXXX

I would suggest you to take a probiotic like Vizylac twice daily with isabghullu husk 2 tsf once daily with XXXXXXX warm water before going to bed at night.

Please attach a photo of stool if possible.

Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ramesh Kumar 21 hours later
Hi Sir,

I have attached the photo of the stool.


Thanks, XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 2 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hey have gone thriugh the pictures
It's unformed stool.
Just follow what i adviced for 5 days and follow up with how relieved you feel on a scale of 0 to 10

Thanks
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ramesh Kumar 16 minutes later
Hi Sir,

1)Can you explain what is meant by unformed stool?
2)Is there any serious?
3)Can I get probiotic over the counter in US?
doctor
Answered by Dr. Ramesh Kumar 16 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hi dear,
Unformed stool means that consistency and thickness of stool is not normal.
A part of it is either too soft or hard.
Most likely cause is improper digestion of food due to disturbed gut flora.

No by taking probiotics things would be much better in few days.
Yes VSL# 3 is available otc in US!

Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2438 Questions

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