Piles (Haemorrhoids)If Bleeding comes Painlessly, as a spurt or as few drops of blood after the motions, it is usually due to “piles”.If bleeding Is occasional and in small amounts,
1. Proctosedly Ointment – apply inside the anus with finger(1H-1) 2. Cremaffin 3 tspHs x 10 days (Lubricant Laxative = Liquid Paraffin = 1G-4) 3. Tab Venusmin 300mg x 2 bd x till bleeding is controlled = 4-6 wks. (Diosmin = 1H-2) 4. Tab Pilex 2 tds x 30 (ayurvedic =1H-3) 5. Cap Autrin 1 ODx 30 (Iron + Folic acid =2I) 6. Refer the patient to surgeon if :
If bleeding isnot controlled or severe or persistent. If patient has become anemic. If piles are protruding out of anus. 2. FissureIf bleeding comes as a streak, by the side of the faeces, amounting to 3-4 drops, and in associated with severe pain and burning during the act, Plus persistent burning several minutes later, it is due to acute “fissure-in-ano”
1. lignocain Jelly x apply locally 4-5 times/day and after every motion. 2. Hot hip bath ie sit in a tub of warm water x 10 mins x 2 times/day. 3. Creamaffin 3 tsp x at bedtime x 2-3 wks. (Liq. Paraffin to soften stools = 1G-4) 4. Tab combiflam 1 tds x 5 dys (anti inflammatory + analgesics = 3C-3) 5. Cap Baciclox 500 mg tds x 5 (antibiotic to control infection =7A) 6. if no relief with above treatment, refer to surgeon for fissurectomy or anal dilation.
3. Blood Mixed with stools. If blood is mixed with stools,usually with mucus also – it si due to bleeding in coln. In young patients, think of amoebic dysentery. In old patients, think of carcinoma of colon.
1. T. FASIGYN DS 1 bd x 3 (Tinidazole = 1F-2) or T. Secnil 1g x 2 stat (Secnidazole= 1F-3) or T. Dyrade. MDS 1 tds x 5 (Metronidazole combination. 1F-7) 2. if no relief, Refer to surgeon or Endoscopist for sigmoidoscopy & colonscopy.
4. Bleeding P.R. in a child Bleeding P.R., with a small cherry red mass coming out is due to a “Pedunculated rectal polyp.” Refer to a surgeon for excision.If a patient aged 60 years or more complains of Bleeding P.R, then sigmoidoscopy or colonscopy or Barium enema must be done to rule out malignancy. Always do as per rectal digital examination, with a gloved finger, to look for hard mass in anus or rectum.
Proctosedly Ointment Cremaffin Tab Venusmin Tab Pilex Cap Autrin Tab combiflam Cap Baciclox T. FASIGYN T. Dyrade TinidazoleLIGNOCAINEFASIGYNSECNIL FORTE
