patient coming with this ....this appears only at the time of toilet.......a burning sensation is there and itching is also there......this happens before 1 month........Plz help in diagnosis and treatment......

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Sir Acc to pic... its Hemorrhoids case..... Rule out by finger DX and proctoscopy for assessing of internal bleeding piles mass,anal fissure and ask d bowel,habits......first give conservative TT. For eg. Rx.. 1.Arshoghni vati 1 TDs 2Gandhak rasyan1 TDs 3.Trifala guggulu vati 1 bd 4.Abhyaristha 10 to 15 ml WD same quantity of wtr..bd 5.Panchasakr churna 1 tbspn aft meal at night WD Luke warm wtr. 6.Apply pichu kasisadi tail and jatyadi ghrita... 7.When symptom r not subsided So u can go kstt aft necessary investigation.
I wants to add Sitz bath.... Rest everything is perfect for 1st line of treatment then we can plan KS Ligation.....
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You need proctoscopy 1st Then rule out Fissures too According to Image patient having Thrombosed Pile Mass which immediately needs Kshar Sutra Management Advice for Sitz bath to get immediate relief Go through routine investigations and plan for KS Ligation @Dr. Abdussalam Siddiqui sir
Arshkuthar Ras 2 BD Arogyabardhani bati2 BD Gandharv haritaki 2 BD Sutsekhar Ras 1 BD Kanchnar guggul2 BD kankayanbati I BD Abhayarist30 ml with coster oil 10 ml mixed up BD N Apply Mahamarich yadi tail piuchu.
Arsh kuthar Ras Triphla gugglu Chitrakdai vati Pilex oint locally Sitz bath Abhyarista pathya apathya should be followed
You can add kanchanar guggulu, kankayan vati
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Haemorroids,,?,,RX. Abhayarista10 ml bid,,pilex ont ,kul tab 2 bid,, sukha virechana regularly. Avoid spicy food.
Agree with Dr.SHAH sir
Tx u sir
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Regular virechan
पाइल्स
1st degree piles or Aisha. Ask history of grahani or Atisaar recently. Ask for Agnimandhya. Treat causes of Co stop at ion if any Triphala guggulu 500mg to 750 mg twice at 9,am and 5,pm. Application of pilex ointment before and after defecation. Sitz bath in termaric water or mild triphala decoction. Gandharvaharitaki choorna at bedtime with hot water Kamdhudhaand shouktik Bhasma 250 mg each SOS if ithcing persist.
Dx Arshas Rx Cap Koile 2BD before food Amroid ointment L/A Sitzbath with Panchavalkala kwatha *Diet :intake of fiber diet, fruits like banana, mango, kharjura etc., Buttermilk, increase water intake, avoid spicy food, Modifications at the field of work Ashwa sanchalan pranayama Correct sleep distrubance*
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