I have internal piles grade 3 and today I saw my anus uter muscles seems to swollen little as it gives pe little pain. Should I take pilex tablets and I am a tb patient (for lump in my neck) I take 5 tablets everyday so will it affect my health as I will be taking these many tablets .i apply anovate everyday but do not see any results can you tell how many times should I apply anovate in a day and how many tablets should I take please?

Dr. Tata Lokesh KumarGeneral Surgeon6yrs exp

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Grade 3 majority of cases need surgery they can't be manage medically. Your case need further evalution consult meee.  

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Dr. Anjanjyoti SarmaGeneral Surgeon22yrs exp

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Kindly understand that it is not the number of times you are applying the ointment. It's the way you are applying and the timing that matters. Please apply twice daily before going for defaecation with your finger inside, and before bed. Pilex tab you can take twice daily for 3 weeks. But most importantly, you need to take care of your stool consistancy. Take plenty of water. Veg.take hot sitz bath. For grade 3, you might need sclerotherapy and barron banding. It will be better to consult a surgeon nearby.  

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You should avoid constipation which may also be one of the reasons for the pain. You have syp duplalac 1 teaspoon at bedtime for constipation. You can apply anovate just before and after passing stools. You can apply once at night also. You can try sitz bath with lukewarm water with a pinch of kmno4, two to three times a day.  

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