What is the treatment of piles at Primary care whr examination of rhe patient is not feasible?
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..
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
Cases that would interest you
- Login to View the image
1 year old child presented with h/o abdominal distension, right upper quadrant mass, intermittent abdominal pain along with vomitting and constipation. CECT if child is represented below.
Akshay Sharma7 Likes27 Answers - Login to View the image
A Fuc chondrosarcoma Rt thigh post op/ post Rt. Presented with unilateral massive Rt lower limb lymphedema. Coloured doppler was normal. Got a PET CTdone. Pls discuss further management.
Dr. Sunny Jain3 Likes18 Answers - Login to View the image
Dx Rx Please Pt Age 15 M Such a Reddish Bacne on Back with itching. How To Treat?
Dr. Abhijeet Auti1 Like19 Answers - Login to View the image
72 year old lady complaints of abdominal distension, Constipation, kindly describe the findings.
Dr. Abdullah. A1 Like15 Answers - Login to View the image
35 year old male came wid complaint of painful defecation....with constipation ....wat is d diagnosis nd treatment???
Dr. Sunil Joshi1 Like21 Answers
2 Likes