Brief Answer:
Need some dietary modification along with treatmen

Detailed Answer:
Hi XXXX! Good evening. i am Dr Shareef answering your query.

From your history, I agree with your doctor that possibly you have developed a fissure in ano ( a cut in the perianal skin) due to passage of hard stool because of which there is initially itching followed by pain over there due to the super added infection.

If I were your doctor, I would first examine the area clinically, and after confirming that it was a fissure, would go for some anti inflammatory drug along with a proton pump inhibitor, a broad spectrum antibiotic, and a stool softener like lactulose liquid at bed time. Add sitz bath to it (sitting on a XXXXXXX warm water filled tub) three to four time a day for five minutes each. Application of a local cream/ointment containing a calcium channel blocker like Diltiazem also helps and you might have to apply this locally at least for 6-8 weeks for a satisfactory outcome. I am hopeful that you would get relief with this strategy, but I am afraid it would return if constipation (hard stool) occurs again for you. Therefore, to prevent the constipation, please avoid high protein diet, add a lot of roughage and fresh fruits along with sufficient liquids. Go for a regular exercise programme.

In case this recurs again and again, and there is no relief with increase in the pain and discomfort, I would advise you to get it assessed by a general surgeon in your area, who might advise you for lateral sphincterotomy ( a surgery where the sphincter mechanism of anal canal is slit to make it resist less for the out coming stool). This usually provides a permanent relief.

I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.

Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef

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