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Suggest Treatment For Severe Pain Due To Constipation

Posted on Tue, 3 Feb 2015

Question: Lot of pain Bcoz of constipation, taking sitcom forte and applying Anobliss cream but no relief. Minor bleeding sometimes . Please advise

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
Looks to be Fissure-in-ano

Detailed Answer:
HI.
Thanks for your query.

Constipation can cause either a piles and / or a fissure.
The pain due to constipation is usually due to an anal fissure, a small wound at eh skin surface of the anal canal. It burns a lot, can bleed a few drops sometimes.
One can feel a small cut like wound and a small skin tag in some cases.

Occasionally a thrombosed and prolapsed pile also can cause pain, the pain here is continuous and throbbing, not burning.

Sitcom Forte tablets works for piles only.
Anobliss cream is useful in anal fissure.

I have few queries for you:
Have you consulted any General Surgeon and got confirmed whether you have a fissure and / or piles ?
Any other treatment taken ?

Your case looks to be more of Fissure-in-ano (Anal fissure)
I would suggest you the following:
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation.
Laxative for softening the stool- never allow the dose too much to cause liquid stools.
Sitz bath- very important- just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5 day course of an antibiotic on prescription of a local Doctor.
Add probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.

I hope this answer helps you to get a proper guideline for proper diagnosis and treatment .Please feel free if you want to know more or if you feel there is a gap-of-communication.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. T Chandrakant (10 hours later)

Thanks.
I did see a doctor, he said its Fissure.
But the medicines and laxative he has given is not working.
I will use liquid povidone iodine as suggested by you.
Can you please name the antibiotic?I feel deep pain after defecating hence need some instant relief.

Answered by Dr. T Chandrakant (16 minutes later)

Brief Answer:
Cefixime or Oflaxacin

Detailed Answer:
Hi.

Try Liquid Cremaffin plus 1 to 2 tsf at bedtime according to the results you get and adjust the dosage as per your individual requirement.
Sitz bath is very important.
Antibiotics and some good painkillers need Doctor's prescriptions, get a prescription for Cefixime or Oflaxacin and Tramadol is the best painkiller (take in the morning before defecation and only when required).

Take proper care, this heals.
Maintain the diet, lax stools and good intestinal hygiene to avoid recurrence.

If this is chronic or you had more than 3 attacks till now, you may opt for anal dilatation under GA or internal spincterotomy whichever your Surgeon feels proper in your case after a careful history and proper examination.

Get well soon.

Above answer was peer-reviewed by : Dr. Shanthi.E