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Diabetes, on urine therapy, have pain at anus with protruding tip, on oats and buttermilk. Could it due to fasting?

My husband of 55 yeras of age had diabetes .Sugar level was - fasting250 and after meals-300 to 400. he started Urine therapy . Sugar level has come down to 150-170. But he has developed pain at anus point. Tip has come out little. he has pain. He is having Oats and lots of bittermilk. Why that piles has come. Is it because he is fasting? Please guide me.
Asked On : Tue, 16 Oct 2012
Answers:  2 Views:  107
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Internal Medicine Specialist 's  Response
Welcome to HCM
Your husband is having two problem one is uncontrolled Diabetes and piles or some other ano-rectal problem.
He must take diabetic diet according to his weight approximately 20 tp 25 Kcal/kg body weight and include fibres in diet soluble and insoluble and good amount of water.Oats and buttermilk can be taken along with other diet. He should take antidiabetic drugs after consultation with Physician/Endocrinologist or he may be started on insulin before major meals as his blood sugar was > 300 mg/dl, Urine therapy ? is not recommonded .
For ano rectal issue he should see a General Surgeon ,he may be having haemorrhoids thrombosed and prolapsed,or any rectal prolapse?, after internal examination and proctoscopy condition may be diagnosed accurately and can be treated accordingly.
Please take care
Answered: Wed, 17 Oct 2012
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General & Family Physician Dr. Divya Kuttikrishnan's  Response
Hi there.

Thanks for writing in.

Your husband might be having a case of hemorrhoids (piles)/anal fissures. Most common cause of both the conditions are constipation and not enough fibre/water in the diet.

Is there any bleeding from the rectum?
Any history of constipation?
Why is he fasting? Diabetics should have frequent small healthy meals.

If he is fasting, one possibility is that not enough food, not enough water leading to no good bowel movements, constipation, leading to either anal fissure ( small tear in the anal canal) or hemorrhoids(piles).

He can have an over the counter pain relief medication . In addition he can sit in a tub of warm water up to his hips (sitz bath ) 4 times a day for pain relief. Isabgol might help with good bowel movements.

I would advise him to have plenty of green leafy vegetables, salads like cucumber.Avoid refined foods like maida, white rice. Have plenty of whole grain foods like brown rice, chappathi , oats etc. Preferably avoid non-veg food like mutton, chicken etc.

Oats is good for healthy bowel movements. Let him continue having oats, but make sure he is drinking enough water(at least 8 glasses of water a day) .Lot of fibre food in the absence of water in the diet can aggravate constipation.

Exercise in moderation is good. Please consult his doctor before starting any physical activity.

In addition, to confirm the diagnosis of piles/anal fissures , please see a general surgeon, who would be able to further help you out with the treatment. If it is a mild case there is no need for further treatment, the above measures I have mentioned above should help. If it is a severe case of piles, then we have to consider other modalities of treatment.

Hope this helps

Dr. Divya Kuttikrishnan

Answered: Tue, 16 Oct 2012
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