Godrej Memorial Hospital

Hi!

I am Dr. Jiten Chowdhry. I am a surgeon by profession. My area of expertise is a painless correction of the anorectal problems. Today I am going to talk to you about the very prevalent conditions like fissures and piles and that too non-surgical or medical management of both these diseases. But before coming to the treatment part I want to make you understand the fissure or piles are basically caused by constipation. Anything which will cure constipation will cure both these diseases especially if they are not acute. If the if they are acute, the fissure can still be treated with the medicines, with the help of some analgesics, some creams and with the help of some laxatives.

So before any treatment, we have to correct constipation because that is the culprit which causes both the diseases. Now constipation can be treated by some natural ways such as drinking lots of water and especially if you take hot water in the morning and that too almost a liter of it, it will relieve constipation very effectively. Apart from having the more water, we have to increase roughage in the diet that roughage can you can get it from the vegetables, you can get it in the forms of various salads and also there are over the counter available preparations like isabgol or there are various fibers available on over the counter which you can take it from the pharmacist or your doctor can prescribe which help you get to relieve the constipation.

And in addition to that, you have to avoid tea, coffee and alcohol. See tea, coffee and alcohol contain a diuretic. Once I say diuretic means it causes more of formation of urine. So whatever water you drink goes more in the form of urine and less is left for your intestines. So, ultimately leading to constipation. Now, these are natural ways. Apart from the dietary thing, one has to exercise also regularly. What we say in our language is if you don't move your bowels also not going to move. So make it a point, you should exercise at least try to walk for some kilometers in a day so that your bowel also moves.

Apart from the medicine, apart from the constipation treatment there are certain over the counter drugs which are available like and there are some muscle relaxants which basically act on the smooth muscles like diltiazem and nitroglycerine; your doctor will prescribe those medicines and you can apply locally there. What these medicines basically do is basically relaxes the smooth muscles of that area which we as doctors call it as a sphincter. So whenever you go to pass your stools that area instead of getting contracted, relaxes. Since this relaxation is very very important because unless until you get the relaxation your every act of defecation, every act of whenever you go to pass your stools will cause injury to your that area and you'll have suffered from pain and bleeding. To avoid that, you have to apply that cream and especially before going to the stools.

So after applying the cream try to wait for 2 to 3 minutes so that the effect of the cream is already there, that the drug is taken up there, the sphincter relaxes and then you pass it with some comfort. So this is very important. Then another thing which is very important is sitting in a tub of hot water. See hot water does three things: it basically increases the blood flow in that area, it cleans that that cleans that area and removes the toxins also. We in our language we call it a sitz bath. These are the three pillars of treatment. One is basically making the stool soft using laxatives or some natural means. The other is sitting in a tub of hot water and the third is applying a local muscle relaxing creams like nitro-glycerine and diltiazem. But we have to understand when the fissure is fresh or it is acute, these things can help to cure the fissure completely but you have to have patience and take the treatment for at least 20 to 30 days to have the full effect but if you don't do that now you are fissure is going to become chronic and once it becomes chronic then you have to go for the surgery.

Now coming to the piles, piles or hemorrhoids what we call in our medical language or in the common language we call it as mulvyadh or bawaseer is also can be treated by medical management especially when it is only in the first or second degree of the stage. In our literature, we divide hemorrhoids into 4 grades but it is out of the scope of this video to tell the various grades. Only thing is you have to understand what many diseases in the initial stages it can still be managed by avoiding constipation. So the major thing is you have to avoid constipation by anyhow. But what I want to convey more than the treatment part is that don't be afraid of anything, don't have any social taboo, don't have any shyness among yourselves because there are so many various conditions which can present similarly like fissure or piles but they can be of very sinister gravity like not to tell you about it can be like cancer, it can be ulcerative colitis or Crohn's disease and if you delay in the treatment, you will have a very very bad outcome of the disease. So, the main thing is you have to come to me or to some other doctor which is near you and show him and get evaluated and examined at least.

For more information, you can contact me on Lybrate.

Thank You