40 y M c/o gases constipation symptoms of acidity p/h/o hemorrhoids sos nondiabetic and nonhypertensive.by profession he is bus driver.

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Seems fissure in ano at antetiorly wid anal budget at 3 and 9 0 clock position ....examine anterior mass if ulcer present....then it's a fissure...conservatively for fissure is to avoid constipation 2 to 4 finger dilatation if not releived go for lateral sphincterotomy

3 and 7...budget buldge
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External hemorrhoids 7 o 'clock Correct constipation,take more fibres

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External Haemarroids c skin tag, likely associated c Anal fissure

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External haemorrhoid If complaints r persisting for longer period then better to go for surgery Haemorrhoidectmy

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Simple case of piles.give lot of veg.Cremaffin liquid to cortect constipation aviod meat

Thanks Dr Majeed.
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Piles.

It's a case of fissure in ano.

More constitution, More more fibres.... First of all get rid of constipation .... And avoid oily and spicy foods.... Apply Rogin e kharateen locally.... And let the patient sit in warm salted H20...

Fissure in ano

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Keep a coin on the anal site .take x ray.that will give you as to how deep you have to go for making anal opening.Better consult G I surgeon

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