Clinically history suggestive of Anal Fissure... However , USG report shows mucosal edema and wall thickening may be secondary to chronic constipation... I would suggest to do sigmoidoscopy to rule out inflammatory pathology like Ulcer, fissure, Hemmorhoids, diverticuli etc.
Looks like chronic constipation . She might be finger evacuating. . Can be SRUS or IBD . Needs colonoscopy
It looks like proctitis, frequently associated with ulcerative colitis.. Colonoscopy and biopsy for diagnosis.. Rectum almost always involved in ulcerative colitis..
Mild mucosal as well as rectal thickening is the report. Patient should be evaluated by per rectal, proctoscopy,colonoscopy. Chronic fissure, solitary rectal ulcer, inflammatory bowel disease may be the differential diagnosis.
First of all DRE to be done Followed by Proctoscopy and colonoscopy to be done Put her on laxative and seitz bath
Pt . Needs proctoscopy or fib
Colonoscopy nd biopsy may give some clue
Cases that would interest you
- Login to View the image
Friends today I am discusing about Piles (Hemorrhoids) . Homeopathic medicine for piles Piles or hemorrhoids refer to swollen, dilated, engorged veins in and around the anus. In this condition, the veins around the anus or lower rectum become swollen and inflamed. Hemorrhoids are a problem in both men and women. Homeopathy medicine for piles is prescribed according to individual symptoms to treat the condition on a long-term basis. The leading causes of piles include a sedentary lifestyle, prolonged sitting, chronic constipation, chronic diarrhea, low fiber content in the diet, excessive use of alcohol, obesity and increased straining during defecation. Pregnancy and genetics also play an essential role in the development of piles. The top homeopathic medicines for piles are Aloe Socotrina, Muriatic Acid, Ratanhia Peruviana, Hamamelis and Collinsonia Canadensis. Why Choose Homeopathy for Treatment of Piles? Conventional treatment for piles involves the use of medicines that make the condition more manageable but do not help treat it. These medicines offer temporary relief from the symptoms, and continuous use is often necessary. Over-the-counter (OTC) medications for piles include ointments, pads, creams and, painkillers. In case of grade 4 piles (or hemorrhoids) cases, surgery is the only option given to most people. Homeopathy offers comprehensive treatment options that help treat the condition and ease the symptoms of piles. Some significant benefits of homeopathy regarding piles/hemorrhoids treatment include: 1. No Side-Effects Homeopathy does not cause any side effects because of these are made of natural substances that are highly diluted. Over-the-counter remedies for piles only help relieve the symptoms, and certain side-effects come with their usage. For example, creams containing corticosteroids are recommended for reducing pain and inflammation for piles, but prolonged usage of these cause skin reactions, increased sweating and growth of body hair, inflammation of hair follicles and increased vulnerability to infections. 2. Natural Remedies to Treat Piles As an ancient 200-year-old medical science, homeopathy uses cures found in nature that help restore the natural healing processes of the body. Homeopathy treatment for piles involves a comprehensive treatment plan that works in harmony with the system. In conventional treatment, use of stimulant laxatives to relieve constipation as a result of piles may cause side effects like abdominal cramps, bloating, rectal irritation, weakness and, pain. 3. Holistic Approach to Treat Piles Homeopathy aims to treat the problem internally, by understanding the cause of different symptoms instead of suppressing them. OTC drugs, ointments and other symptom-relieving options only provide temporary relief. Out of ten people, at least one person is recommended for a piles-related surgery. This invasive treatment has a host of complications, like difficulty passing stools and urinary tract infections post-surgery. Surgeries like hemorrhoid stapling may cause complications like rectal prolapse (part of the rectum pushes out of the anus) and hemorrhoid recurrence. 4. 4. Individual Treatment Homeopathy works by analyzing the individual symptoms of the disease in a person. There is no blanket treatment provided for a particular illness since every individual is treated according to their specific symptoms. For example, for a person dealing with piles with painful defecation, the medicine Muriatic Acid is prescribed. In case a person suffering from piles complains of bleeding along with stools, the medicine Hamamelis Virginiana is prescribed. 5. Simple and Effective A single dose of the correct medicine can help relieve the symptoms and also treat piles to a large degree. By restoring the internal processes of the body, these medications help address the condition naturally and effectively. Invasive procedures like surgery can be held-off with the help of homeopathy. 6. These are Safe Medicines for piles treat the problem by reducing the engorgement of blood in the rectal veins as well as improving blood circulation. Unlike conventional drugs for piles that are usually not recommended to be taken for more than seven days in a row, these medicines are taken in small doses over a continuous period. This helps improve the efficacy of the natural substances in the medicines, which in turn thereby helping reduce the severity of the symptoms and treats the problem on a long-term basis. Homeopathic Medicines for Piles Depending on the grade, severity, and symptoms of piles, different medicines are recommended to decrease the severity of the symptoms and treat the condition on a long-term basis. 1. For External Piles Aloe Socotrina is a medicine used to treat for external piles that are sore and tender. Sharp or burning pain in the rectum and a constant feeling of bearing down in the rectum may be felt. Application of a cold compress may help relieve the pain or burning sensation. This medicine is also used to treat anal fistulas. 2. For Painful/Protruding Piles Muriatic Acid is a medicine used to treat conditions of piles that are intensely painful, sore and protrude outside the anus. The hemorrhoids are very swollen and look bluish. The pain may get worse while passing stools. Stitching pain that gets worse on touch is present, and it gets better from warm-washing. This medicine is also used to treat cases where the soreness in the hemorrhoids worsens during menses in females. 3. For Piles with Burning Sensation Ratanhia Peruviana is a medicine used to treat piles where a burning sensation after defecation is present in the rectum. The person may have to strain to pass stool. Knife-like stitching pains in the anus or the feeling of a sharp splinter of glass in the rectum may be present. 4. For Piles with Bleeding Hamamelis Virginiana is a medicine used to treat piles with profuse bleeding. Weakness due to bleeding, soreness at the anus, hard stool and anal-itching are other symptoms that indicate the need for this medicine. 5. For Piles with Constipation Collinsonia Canadensis is a medicine used to treat piles accompanied by constipation. The stool in such cases is lumpy, dry and is passed with a lot of strain. Other symptoms include aching and burning at the anus, a sensation of sharp sticks in the rectum, anal-itching and a constricted sensation in the anus. 6. For Piles with Shooting Pain Aesculus Hippocastanum is a medicine used to treat piles with sharp, shooting pains where the stools are knotty, dry and hard. This medicine is used to treat external, blind and bleeding piles. 7. For Blind Piles Nux Vomica is a medicine used to treat blind piles where there is pronounced burning and itching around the anus. A constant desire to pass stools may be there, but constipation and passing of scanty stool is the main symptom. Pulsatilla Nigricans is a medicine used to treat blind piles with a cutting, sticking or burning pain. The pain gets worse during lying down. Itching in piles and constipation with a backache and pressure in the rectum is another symptom. 8. For Piles caused by Childbirth Sepia Succus is the medicine used to treat piles that develop after the delivery of a child. It is also used in cases of constipation where the stools are very hard. Kali Carb is a medicine used to treat piles in females that develop post childbirth. The piles are extremely tender to touch. There may be stitching, smarting, pricking and tingling sensation at the anus along with sharp pain. Constipation lasting for days along with hard stool, and white mucus after bleeding from piles may also be present. 9. For Piles and Anal Fistula Silicea is a medicine used to treat piles and anal fistula. The piles tend to protrude during the passage of stool. The stool is hard and tends to recede into rectum several times during defecation. Burning in anus after passing hard stools, and a foul-smelling discharge of pus or serum from the anal fistula may also be present. 10. For piles with Chronic Diarrhea Merc Sol is a medicine used to treat piles in people suffering from diarrhea. There is an urge to pass stool, more frequently during the night. The stools in most cases smell sour and are undigested bits of food. Burning at the anus while passing stools, protrusion of piles during defecation, exhaustion, and chilliness with shivering and a feeling of nausea is also present. 11. For Piles Protruding during Urination Baryta Carb is a medicine used to treat piles which protrude during urination. Other symptoms that indicate the need for this medicine include an urgent need to pass stools, and an itching, burning, soreness and shooting pain in piles. 12. For Piles Protruding during Cough/Sneeze Lachesis Muta is a medicine used to treat piles that protrude during a cough or sneeze. In most cases, a stitching pain and a throbbing sensation in the piles is present. Piles in females during menopause are also treated with this medicine. 13. For Piles during Pregnancy Sepia Succus is a medicine used to treat piles that develop during pregnancy in females. The piles may be bleeding or non-bleeding, and a protrusion of piles during stool occurs. Itching at the anus and rectum, constipation and the presence of hard and large stools also indicate the need for this medicine. 14. For Piles during Menses Ammonium Carb is a medicine used to treat piles that get worse during the menses in a female. The piles tend to bleed during menses, and the affected person feels better upon lying down. 15. For Piles with Rectal Prolapse Lycopodium Clavatum is a medicine used to treat piles in cases where there is a rectal prolapse. The piles may be swollen and painful, and the pain gets worse upon touching and sitting. Chronic constipation with a scanty stool, painful constriction at the anus and excessive flatulence and bloating in the abdomen may also be present. 16. For Internal Piles Phosphorus is a medicine used to treat internal piles where there is bleeding during stool. Excessive exhaustion, an urgent need to empty bowels and rectal tenesmus (desire to evacuate the bowels) are some other symptoms. 17. For Large, Swollen Piles Causticum is a medicine used to treat large, swollen piles that hinder the passage of stool from the anus. The person needs to pass stool by straining hard in a standing position. The piles are hard, painful and constant and get worse upon sitting, standing and walking. There may be a pressing and sticking pain in the anus along with a burning, stinging sensation. 18. For Piles and Anal Fissure Nitricum Acidum is a medicine used to treat piles and anal fissure when there are tearing pains in the anus while passing stools. The stool can be hard or soft but is passed with difficulty and may also bleed. There may be splinter-like pains in the anus. 19. For Itching Piles Sulphur is a medicine used to treat piles when there is a soreness and tenderness at the anus along with a hard, knotty stool. Weakness after passing stool, excessive rectal pain, and a biting sensation at the anus that gets better upon lying down are some other symptoms that indicate the need for this medicine. 20. For Piles with Pain after Stool Sedum Acre is a medicine used to treat painful piles that feel worse after a few hours of passing stool. In a majority of cases, the pain is constricting. Sedum Acre is also useful for treatment of anal fissure with pain that worsens a few hours after passing stool. For Piles that get Worse during Sitting Graphites Naturalis is a medicine used to treat painful piles that get worse during sitting. Cutting pains and swelling with cracks at the anus are present. The stool tends to be hard, knotty and scanty. The Different Types of Piles Piles are of different types, classified according to their location and whether they bleed or not. External piles, internal piles, protruding/prolapsed piles and blind piles are the most common types. External piles are present on the skin around the anus and can be seen or felt from the outside. The main symptoms of external piles include painful swelling and hard lumps around the anus. If these hemorrhoids get irritated, they may cause itching or bleeding. Internal piles lie deep inside the rectum and cannot be felt or seen from the outside. They are mostly painless since there are no pain receptors in the region where they tend to appear. The only symptom of internal piles is bleeding through the anus while straining during a motion of the stools. Protruding or prolapsed piles are hemorrhoids that get pushed out towards the anus when a strain is applied to pass stools. They look like pink, moist pads of skin. Prolapsed or protruding hemorrhoids tend to hurt since the anus area is dense with pain-sensitive nerves. The typical symptoms of hemorrhoids are mucus discharge, itching, and pain. Blind Piles are those hemorrhoids that do not bleed. They feel like protruding masses, usually detectable after passing stools, at the opening of the anus. The Different Grades of Piles according to Severity Piles can also be classified into grades, according to their severity. Grade 1 piles are small inflammations that are usually found inside the lining of the anus and are not visible. Grade 2 piles are larger than the grade 1 piles, but they too remain inside the anus. These protrude outside the anus while passing stools and go back into the rectum after defecation. Grade 3 piles protrude during defecation and need to be manually pushed back inside the anus. Grade 4 piles are a severe case. These cannot be pushed back inside and need immediate medical attention. Causes and Risk Factors of Piles Primarily, the swollen veins that are seen in piles develop due to increased pressure in the rectum. This pressure may cause disintegration of the tissues supporting the anal walls, leading to hemorrhoids. Various factors contribute to causing this kind of pressure: Irregular Bowel Movements Factors like constipation, straining to pass stools, overuse of edemas or laxatives, chronic diarrhea, spending too much time on the toilet add to the strain on the rectum and anus, leading to the development of piles. Diet Lack of a fiber-rich diet, low water intake, excessive intake of alcohol, consumption of over-spicy food and junk food also contribute towards this condition. Pregnancy There is increased pressure on the abdomen and pelvic area during pregnancy, which is a leading cause of piles during pregnancy. In some cases, hemorrhoids develop as a result of childbirth due to the excessive pressure on the rectum and anus. Age and Heredity Other factors like age and heredity can contribute towards the development of piles due to the weakening of the tissues supporting the rectum and anus. Portal Hypertension Portal hypertension refers to a condition where there is an increase in the blood pressure within the veins of the portal venous system. The veins coming from the spleen, stomach, pancreas, and intestines merge into the portal vein, which travels through the liver. In case of any complication due to which blood cannot flow properly through the liver, a high pressure develops in the portal system. This pressure can cause the development of large, swollen veins in the stomach, esophagus, and rectum. As a result, hemorrhoids may develop in the anal area. Symptoms of Piles Pain in the rectal region is one of the first signs of piles. Pain experienced while passing stools, painful lumps in or around the anal area, swelling and blood in the stools are the most common symptoms of piles. A small mass of skin may protrude out of the anus upon defecation. The area around the anus may feel sore, red and itchy. In some cases, a feeling of fullness may remain, despite having passed stools. Larger piles can cause discomfort in the form of pain, itching, and mucus discharge. All these symptoms need a clinical diagnosis to rule out the presence of any other rectal problems. A visual rectal examination, anoscopy, and colonoscopy may be required. Piles or hemorrhoids can sometimes lead to further complication escalate into a more severe condition. These include excessive anal bleeding that may lead to anemia, incontinence, anal fistulas, and infections or clots within the hemorrhoids. Q. I am passing blood with stools, is it indicative of piles? Bleeding with stool is one of the primary symptoms of piles. However, blood in the stool may appear from many other conditions like anal fissures and severe conditions like ulcerative colitis or any malignancy of the GIT. Further investigation by a physician may be required to determine the exact cause of bleeding. Q. Is anal itching indicative of piles? While anal itching is one of the symptoms of piles, it may also be present due to other conditions like worm infestation, anal fissures, anal fistula or a skin complaint around the anal area. Other symptoms like painful defecation, bleeding with stools, burning/soreness at the anus or swelling are also indicative of piles. A physical examination of the anal region may be required to pinpoint the exact problem. Q. If I feel a mass protruding out of the rectum while passing stools, is it piles? A mass protruding from rectum while passing stools can be indicative of two conditions – piles and rectal prolapse. A rectal examination is required to know the exact cause. Q. I have piles with excessive swelling around the anus and painful defecation. Will applying ointments solve my problem? Ointments may help in temporarily reducing the discomfort and soothe the symptoms of piles. To cure piles, a proper treatment that helps reduce the engorgement of the rectal veins and ensures adequate blood circulation in the veins is required. Q. I am suffering from piles with constipation; can I take a laxative? A laxative is a short-term solution for the management of constipation, but proper treatment is required for long-term treatment to improve the bowel motility and reduce engorgement of blood in the rectal veins. Q. Can I avoid piles surgery with the help of medicines? Yes, natural medicines work to stimulate the internal healing processes of the body, and with long-term use, they can help manage piles without surgery. It should be noted that the results vary from case to case, depending upon the severity of the problem. Q. For how long do I need to take medicines to treat piles? The length of treatment for piles depends upon the duration of the symptoms, their intensity, and how quickly a person responds to personalized medicines. The treatment period can range from a few weeks to a few months. Q. Is surgery a permanent solution for piles or do piles recur after surgery? Surgery for piles is not a permanent solution since in most cases, chances of recurrence are high. It does not treat the cause behind piles. For a permanent solution, the cause of increased rectal pressure and poor blood circulation in the rectal veins needs to be identified and treated. Managing Piles in Everyday Life Foods that Help Treat Piles High-fiber foods like figs, flaxseeds, quinoa, beans, lentils and fresh fruits and vegetables help keep the system healthy and aid in maintaining proper bowel movements. Fresh plant-based food eaten with the skin intact provides a decent amount of fiber. Some also contain a lot of water; watermelons, celery, and cucumbers are made up of almost 90% water. The aim is to ensure that the stools do not become hard and constipation is avoided. Clinical research shows that in case of non-prolapsing hemorrhoids, taking a fiber supplement helped reduce the risk of persisting symptoms and bleeding by almost 50%. Foods to Avoid During Piles Foods with little or no fiber can cause constipation, or worsen the condition, indirectly leading to hemorrhoids. Foods like milk, cheese, and other dairy products should be avoided, as should meat, processed and frozen food. Alcohol, caffeine, excessive salt and spicy food can also worsen the condition. Certain supplements like Iron can lead to digestive problems and should only be taken on the recommendation of a doctor. Staying Hydrated to Prevent Dehydration Dehydration leads to constipation because water is required for the fiber to be able to travel smoothly through the digestive tract. Dehydration and constipation can worsen the symptoms of hemorrhoids. Eating water-based fruits and ensuring an adequate amount of water intake are simple measures to prevent dehydration. homeopathic piles exercisePracticing Healthy Toilet Habits It is essential to understand that the toilet habits practiced on an everyday basis are directly linked to piles. Over-straining during defecation can increase the pressure on the hemorrhoids and worsen the condition. An urge to pass stool should not be ignored, since delaying it can cause the stool to harden. Regular physical activity, consumption of adequate amounts of water and fiber and healthy toilet habits can help prevent constipation naturally, and stop the hemorrhoids from getting worse. For those who like to sit and browse their phone on the toilet – prolonged sitting on the toilet causes unnecessary strain on the body and can make the condition worse. It is important to clean up properly after defecation to prevent infections and worsening of the condition. Cleaning should be done gently, not roughly. A warm bath where the person sits in warm water for 10-15 minutes can help relieve itching, burning and aching, while also cleaning the area. Apart from these, factors like obesity and chronic digestive issues also play an important role. Simple lifestyle modifications can help a lot, and regular exercise is key in weight management and maintaining a healthy bowel movement. A holistic approach towards piles can help manage and treat the condition naturally. A physician can identify the underlying causes of the symptoms of piles and help a person transition into natural, safe treatment options with adequate lifestyle changes to treat the problem.Dr. Rajesh Gupta20 Likes20 Answers
- Login to View the image
A 28yrs old female pt having lesson like this in anal canal , associated with pain while passing stools and difficulty in siting, also complaint of constipation since 10days ..plz dx and rx ,Dr. Md Ansari4 Likes21 Answers
- Login to View the image
age 45,male, since six months , constipation, burning sensation on defication,pain, How to manage this case, please advise And suggest medicines,Dr. Ajaykumar Dalavi1 Like8 Answers
- Login to View the image
A 45yrs old male pt having c/o Mass coming out from anal region. severe pain at anal region. unable to sit . unsatisfactory motion since 4-5days. H/o chronic ethanolic nd smoker since more than 20yrs. what should be the line of treatment.@Curofy@Dr. Shivraj Agarwal @Dr. Ram Pawar5 Likes34 Answers
- Login to View the image
### 38 years old man presents with passage of mucus in stools since many days. No pain abdomen. No urgency for stools. No other symptoms. Only passage of extensive mucus in stools. Sometimes there occurs pain and need for defecation. He was given Rifaximin before for IBS but no relief. His all reports are shown below. Kindly comment on the further management.Dr. Shofique Anowar3 Likes23 Answers