What is the treatment of piles at Primary care whr examination of rhe patient is not feasible?

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At primary care - at least examination of anal area can be done - and on examination a tight external anal sphincter and a fissure in ano can be seen .If there are prolapsed haemorrhoids- these can be visualized. If there are haemorrhoids of First and second degree - history of bleeding P/R will be there with no associated pain and blood is not mixed with stools,and drops of blood may come even after act of defecation. In case of fissure - constipation is prominent , pain is severe during defecation after the act for few minutes and bleeding is less - but stools may be slightly blood tinged.. If Haemorrhoids- treatment is 1.dezoflav 1000 mg t.d.s for 1 week , B.D for second week and once a day for 1 month 2.Addition of calcium dobesilate t.d.s for 3 weeks will be curative For Fissure- 1 A laxative 2.Topical nifedipene + lignocaine ointment 3 Tab Ornidazole 500 mg B.D for 5 days 4.Tab cefuroxime 500 mg B.D for 5 days, 5.Sitz bath 6.NSAIDS with serratiopeptidase 7.A high roughage diet

If constipation is there ,causing hard and trouble ful stool pass, take Cremaffin at night before sleep. Pay thru applicator, PROCTOSEDYL CREAM BEFORE AND AFTER STOOL PASS. B COMPLEX .. If still uncontrolled,hemmoroidectomy is the alternate..

Stool softener Anovate oini Sits bath Anti inflammatory Antibiotics

DRE is mandatory in case of bleeding p/r. many a times Ca anorectum is easily missed if we go by the complaint of 'piles' and reluctancy from both doctor and patient side for examination.

ANTIBIOTICS WITH NSAIDS AS PER REQUIREMENT.. PILEX OINTMENT.. STOOL SOFTENERS..

Tnx Dr Amitabha Dasgupta
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VERY NICELY. DISCUSSED IN. DETAILS... ..........BY. THE. RESPECTED DOCTORS THANKS

Dear Dr.Govvinda N Sir, Advice for the case. Tab. Suran Vatak 1 tds. Cap. Piles Less 2 BD.

Tab.mobilife sp 1 bd for 5 days Tab.xtum o 1 bd for 5 days Cap .pan d od for 10 days Syrp. Colax MP 15 ml hs Oint. Spear 2 or 3 times apply Sitza bath

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