30 yrs/ m bleeding in stool & pain before 4-5 days take inj amicacin 500 mg bd , inj. Vovran, inj. Trnexa , tab sporidex 500 mg bd use but not improved. Plz suggest dx

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Prolapsed gr 3 or gr 4 piles if not controlled conservatively adv for surgery stappling or lasor but if you want to treat coservative treatment than local application of botroclot lotin or local infilteration of inj botrpase with anometerogyl oint +smuth oint locally and cap hilo 2bd orally with oral sylate-t 1tds give bulk and fiber laxatives.keep followup.
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Haemorrhoids grade 3 Adv haemolit ointment Tab venex 300bd Cap calcium debosilate 500bd Syp abhyarisht wid equal amt of h2o Tab pilex 2 tb bd Tb zanocinoz bd if not controlled Den adv - surgery
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External piles (prolapse) Adv KS ligation
Thanx dr Amzad khan
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Haemorroids
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Pils
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Dear sir, This is a case of 2nd to 3rd degree internal haemorrhoids @ primary position with spasmodic anus. Also along with proctitis ++. Surgical intervention is best option for him. But first we should reduced proctitis by below given medicine for 7 days. Tab Rantac 150mg 1 Bd before meal Tab Oflox-OZ 1 Bd after meal Isabgul husk powder 2 tsf with milk or water before breakfast in the morning & then take plenty of water whole day. Sitz bath 3-4 times a day specially after defecation Don’t straining during defecation. If you feel more bleeding during defecation, stop defecation & come out from toilet. Above process the proctitis will be reduced then plan for surgical intervention. So during operation bleeding is less bcz proctitis reduced. Closed haemorrhoidectomy with Barron band ligation with lord’s procedure under SA.
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3rd degree piles Avoid constipation and indigestion Avoid oilly and spicy food egg fish chicken burger fast food pizza etc Intake Plenty of more water Uses Fibres diet vegetables, fruits Avoid late night dinners. 10 to 15 min walking especially after dinner Isabgol granule at bed time with water Tab diosmin 300 tds Xylocain gelly for LA Setz bath Tab zanocin oz BD x 10days Tab pan D 1bd before meal x 10days Tab voveran SR 75MG BD x 10days
Hemorrhoids. Hadensa oint LA thrice daily Tab-Sidpiles 1 tds Sy-Abhyarist 15ml with some water tds Will give good results U can add haemostatic drugs sos
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For bleeding piles i used mixed Rx pilon 10 -1bd oflox oz 10-1bd buscapan 10- 1bd Liq creamafin plus 3tsf at night proctosedyl oint.locally
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