Follow-up on Anal Fissures/Piles Treatment - #39652

That is a good sign. The Healing response shows your system has responded well to the combination of medicines and diet changes. Since the bleeding and pain completely stopped and bowel moment or slightly improved, it mean, the acute face has settled and your now entering the maintenance phase. You do not need to stop sudden suddenly continue the same 2-0-2 dose for another 10 to 14 days to consolidate healing of the figure tissue and to ensure internal pulse shrink completely. After that, you can safely taper the dose to 1-0-1 for another 3 to 4 weeks as maintenance, this gradual reduction helps prevent recurrence, especially if there is a tendency towards constipation or straining

Continue triphala churna at bedtime with warm water - it helps to keep the stools soft improves digestion and maintains colons tone Make sure your diet stays rich in warm lightly oiled fibre balanced foods moong dal ghee buttermilk Avoid spicy, dry, heavy to digest meals Drink enough for motor throughout the day

Yes continue also take triphala Guggulu 1tab bd and triphala kashaya for sitzbath and apply sunarin ointment Externally

Dr.RC BAMS,MS(AYU) ANO RECTAL SURGEON

HELLO,

CURRENT STATUS -pain and bleeding = resolved -bowel habits= improved -other symptoms= none

You are in the healing and maintenance phase

MEDICATIONS CONTINUATION If you’ve been taking 2 tablets twice daily (2-0-2) for 15days and are symptoms free -next2 weeks= you can safely reduce the dose to 1 tab twice daily (1-0-1)after meals -this helps maintain healnig while preventing recurrence and allows your body to gradually taper down the herbal intensity

if you feel absolutely symptoms-free and your digestion feels balanced, you can even reduce to 1 tab after dinner only in the 4th week- but only if stools remain soft and no strain is felt

2) TRIPHALA CHURNA Continue triphala churna with warm water at bedtime- it keeps bowels soft, prevents recurrence, and gently detoxifies the colon

-If stools become too loose, reduce to 1/2 tsp instead of 1 tsp

DIET AND LIFESTYLE Keep following pitta pacifying and fiber rich diet -warm, freshly cooked meals ; avoid spicy, fried, or very sour foods -include ghee in meals 1/2 tsp with rice or roti - it lubricates intestines -drink warm water throughout the day -avoid sitting for long hours, take shorts walks after meals

LOCAL CARE If you feel dryness or mild discomfort -Apply jatyadi taila or panchavalkala decoction before or after passing stool for local healing

After completing 4 weeks -If still symptom free, discontinue tablets but continue triphala for another month -If any strain, dryness or itching recurs- return to 1-0-1 dosage for 10 more days

DO FOLLOW

HOPE THIS MIGHT HELPFUL

THANK YOU

DR. MAITRI ACHARYA

Since you are feeling better, need to continue the same medicine and dosage for 6 weeks, You can also do sitz bath , put 2-3 drops of betadine in warm water in a tub, sit for 10 mins wah the anal area and apply jatyadi oil. Avoid spicy fried foods, street foods. Avoid nonveg diet.

Since you’ve noticed significant improvement with the current regimen, it indicates your body responded well to the treatment so far. Pain and bleeding stopping is a good sign. You can continue with the same dose (2-0-2) for another 2 weeks, making it a total of four weeks. This helps to consolidate the benefits you’ve gained and addresses any underlying imbalances. After four weeks, it’s generally advisable to taper down. Transitioning to a maintenance dose of 1-0-1 can prevent recurrence.

However, while continuing this treatment, ensure you keep following a balanced diet which you mentioned had positive effects. Include fiber-rich foods like fruits, whole grains, and vegetables, to help prevent further issues. Adequate hydration is crucial, particularly with the intake of Triphala Churna, which can be continued at night with warm water. This facilitates smoother digestion and promotes gut health.

Implementing certain lifestyle habits like not sitting for prolonged periods, gentle yoga, or walking daily could support circulatory health, particularly in your lower body.

It’s important to note that individual responses may vary. If any new symptoms occur, or if the pain or bleeding returns, reassessment would be necessary. In that case consulting with a healthcare provider is recommended. Since you’ve already had such improvements, sticking to the plan while monitoring closely should keep you on the right track.

Based on the remarkable progress you’ve experienced with the current regimen for your anal fissures and piles, it’s promising to hear that the pain and bleeding have subsided. The use of two tablets twice a day, alongside Triphala Churna at night, seems to be supporting your recovery well. This suggests a balance between your doshas and the diet adjustments has enhanced your body’s healing processes - a good sign that your agni or digestive fire is also stable.

Continuing this dosage for another two weeks could be beneficial, though it’s ideally best to slightly adjust the plan if you notice particular improvements or interactions. Normally, after 4 weeks, you may consider transitioning to a maintenance dose of one tablet twice a day (1-0-1), but this step is dependent on how your body continues to respond to the herbs.

Nonetheless, while Ayurvedic principles greatly emphasize gradual and sustained healing, you should also observe how your body feels and any subtle changes in symptoms. Monitor any variation in bowel movements, discomfort, or unusual symptoms, and make sure your diet remains rich in fiber, hydrating, and supportive of your ongoing recovery.

If after two more weeks on the current dosage you feel stabilized, transitioning to a reduced dose is reasonable. Always best to consult directly with your practitioner to address any specific needs or uncertainties, ensuring safety. If any new symptoms arise, it’s essential to get a clinical opinion immediately.

नमस्ते,

चूंकि अब आप लक्षण-मुक्त हैं, तो आमतौर पर लक्ष्य सक्रिय उपचार से रखरखाव और पुनरावृत्ति को रोकने की ओर शिफ्ट हो जाता है। हालांकि, खुराक में बदलाव हमेशा आपके प्रिस्क्राइबिंग डॉक्टर से पुष्टि के बाद ही करना चाहिए, क्योंकि मुझे आपके द्वारा ली गई सटीक दवा की जानकारी नहीं है।

इसके बावजूद, सुधार के बाद फिशर/पाइल्स के उपचार के लिए सामान्य क्लिनिकल दृष्टिकोण इस प्रकार है:

1) अगर लक्षण पूरी तरह से ठीक हो गए हैं अधिकांश डॉक्टर खुराक को धीरे-धीरे कम करते हैं, अचानक बंद नहीं करते।

एक सामान्य टेपरिंग पैटर्न: -वर्तमान खुराक को 2-3 और दिनों तक जारी रखें, फिर -1-0-1 के लिए 1-2 सप्ताह तक कम करें -इसके बाद, कई डॉक्टर केवल आवश्यकतानुसार उपचार + जीवनशैली उपायों पर शिफ्ट हो जाते हैं

अगर त्रिफला आपको सूट करता है -आप रात में त्रिफला को 1-2 सप्ताह और जारी रख सकते हैं, यह आमतौर पर नरम मल बनाए रखने में मदद करता है। अगर मल नरम रहता है, तो आप बाद में आवृत्ति कम कर सकते हैं।

धन्यवाद,

डॉ. हेमांशु मेहता

Your symptoms (pain + bleeding) are completely gone and bowel movements are improving → this is exactly the response we want.

Updated Dosage Plan (Next Steps) Next 2 weeks (Day 16–30) Continue exactly the same dose: 2 tablets morning + 2 tablets evening after meals Continue Triphala Churna 1 tsp night with warm water

After completing full 4 weeks (Day 31 onwards) Reduce to maintenance dose: 1 tablet morning + 1 tablet evening after meals Continue this maintenance dose for another 4–6 weeks (total 8–10 weeks therapy) Triphala Churna continue at night (prevents recurrence)

Why not reduce early? Healing of the anal fissure takes 6–8 weeks for the tissue to become strong. Reducing before 4 weeks increases chance of recurrence. Since you have no side effects and excellent relief, completing full 4 weeks on current dose is safe and best.

Additional Tips to Prevent Recurrence Never let constipation happen even for 1 day → keep stool soft Sit in warm water tub (Sitz bath) with Triphala water → 10 min daily for next 1 month Continue balanced diet + 1 tsp ghee daily + plenty water Avoid sitting >45 min continuously

You are on perfect track. Complete 4 weeks on current dose → then taper to 1-0-1. No need to worry – recurrence rate is <5 % if you follow this.

Regards Dr Gursimran Jeet Singh MD Panchakarma