age 50 male pt occupation: mutton shop symptoms: burning sensation and pain after stool plz dx and rx

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First rule by finger Dx and proctoscopy for assessing int.piles.....but acc to pic lookes appear like anal fissure wd tag.... If have anal fissure wd tag...... First give conservative tt...for 5 to 7 days Rx.. Pilants cap...1 tds aft meal Bolbadhrasa Ra's...1 tds.a ft meal Trifala guggulu VATI..1 tds aft meal Usheerasava ...1o ml wd same quantity of wtr.thrice Spazyme syp...2 2 2 tbspn ...aft meal Avipattikar churna....1 tbspn at night aft meal wd Luke warm wtr. Give sitz bath ... potassium permanganate. Apply pichu of kasisadi tail and jatyadi ghrita. Suggest pathya and apathya... If problem will not be solved...so u can go wd Lord dilation and remove d tag by agnikarma or ks LIGATION.....wd necessary investigation. Thanks wd regards... @Dr. M.s.b Babu saheb ji.

Tq so much for ur valuable suggestion @Dr. P. G. Shah sir
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Its Skin Tag because of chronic anal fissure..... Agree with @Dr. P. G. Shah sir Better to go with Proctoscopy first rule out Fissure and Pile Mass.... May be anal dilation is needed along with Abhyantara Aushdhi... And for tag you can go with KS Ligation or Agni Karma or Shastra Chedana.... Whichever is suitable.... Its harmless we can also avoid the Tag if fissure is cured.....

Tx u sir
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Sentinel piles Pipalayadi tail ko cotton me dalke ano me apply kr Vivandh ko remove kr Hunger ko increase kr pileborn diet and recreation neglect kr Kankayan vati before meal Abhayarist after meal Arogyawardini in night milk

Fissure in Ano with Sentinel Tag Proctoscopy is contraindicated so fingure test must be done to ruled out

Tq sir
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Looks like a rectal prolapse with or without internal hemorrhoids due to prolonged sitting and may be obesity because of his profession.@Dr. P. G. Shah and @Dr. M.s.b Babu

Sorry mam This is internal fissures with external skin tag, Not a prolapse.
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◾ DX-FISSURE IN ANO ◾RATANHIA PERUVIANA ◾SBL AESCULUS OINTMENT ◾PAEONIA OFFICINALIS Q ◾ACID NITRICUM ◾AESCULUS HIPPOCASTANUM Q

? SENTINEL PILES.. ? PERIANAL SWELLINGS.. NEED'S.. PROCTOSCOPY .. SURGEONS OPINION.. MEANWHILE SYMPTOMATIC T/T..WITH CLINICAL CORRELATION..

I think ,the best option to follow Dr.P.G.Shah ji.every option is open to cure.@Dr M.S. b Babu sir.

Tq so much@Dr. S.k. Mudgal sir ji
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Over-the-counter topical treatments, such as hydrocortisone or hemorrhoid cream, can ease your discomfort from hemorrhoids. Soaking your anus in a sitz bath for 10 to 15 minutes per day can also help. Practice good hygiene by cleaning your anus with warm water during a shower or bath every day. But don’t use soap, as soap can aggravate hemorrhoids. Also avoid using dry or rough toilet paper when you wipe after a bowel movement. Using a cold compress on your anus can help reduce hemorrhoid swelling. Pain relievers, such as acetaminophen, ibuprofen, or aspirin can also alleviate the pain or discomfort.

It's seems to be a case of fissure wd sentinel tag associated wd haemorrhoid. Adv Avoid straining during defecation Reduced toilet sitting time (3-5) min Conservative treatment Kanchnar guggul 2 bd Jatyadi ghrit P/R local application. Sits bath Pwd isbgol 2 1tsf hs wd Luke warm water or milk . If constipation severe then syp lactulose 2 tsf hs SOS Above treatment adv for 7 to 10 days. Symptoms subside continue for upto 1 month. If not go for surgical intervention like excision of analtag, anal dilatation and lateral sphincterectomy.

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