Haemorrhoids

Haemorrhoids with skin tags What us the stage and how to manage it Chief Complaints Painful Bleeding during defaecation History Fresh Bleeding during defaecation from last 6 years Episodic Associated with pain , itching 2 skin tags present at 12 o'clock and 6 o'clock position

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History suggest pt is a c/o fissure ano with sentinel pile First treat conservatively and adv elective surgery Rx tab cefixime+ofloxacin 1bd Tab tremoxen 1tds Or cap pause 1tds Antiinflamatory Seat bath in lukewarm water with savolon lotion Locally anometerogyl oint twice daily Smuth oint twice daily Xylocaine gelly 2% frequently for instant relief Cap pilon 1bd Bulk laxatives Avoid fast fry and junk foods Treat comorbidies like DM/HTN if pt have Also assess obesity and over weight

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Patient having painful bleeding during andfresh bleeding during defaecation for 6 years with anal tags To me it seems to be case of anal fissure causing paiful defaecation with bleeding along with bleeding during defaecation for 6 years with external piles or sentinel piles As tere is pain then to start the treatment for anal fissure for relief of pain otherwise gigital examination or proctoscopic examination will be possible Sietz bath with betadine lotion Stool softner or laxative to make stool soft Xylocaine jelley 2% to apply locally 15 minutes before and after defaecation Anal gesic and antibiotic If the pain subsides or became less then gigital examination to see any pain for detection of fissure and to look for internal piles and to see the degree of piles. Some simoidoscopy required to see any cause high up causing bleeding Teatmentbas per the finding.

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Infected piles.

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chronic fissure in Ano wants stool softners Analgesics Tropical ointments Sits bath

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