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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33894
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I am concerned about my 18 Year old, Last week she said she

Customer Question

Hi , I am concerned about my 18 Year old , Last week she said she was constipated and she strain a little the next day she seen blood on her tissue and a lil in the toilet , I checked her stool and it seems normal ,medium ,light brown and yesterday she said she use it and pushed a little and nothing and this a.m nothing and when we got home she seen some.again ,it is bright and seem to be on the outside of her stool .she use birt/contr pills(mononessa) and her derm gave her Doxycycline Hyclate
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello Sharon,
I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.

The blood in stool is not due to birth control pills. This is likely due to hemorrhoids.

The treatment of hemorrhoids is by warm sitz bath, avoiding straining, keeping the stools soft and local application of the ointment like proctosedyl or Preparation-H. Following is the detailed advisory;

1) Avoid constipation by not postponing the urge to defecate; Many over-the-counter options helps speed bowel movements and decrease straining. Duphalac is best. A soft stool helps in decreasing the irritation and associated swelling of hemorrhoids.

2) Eat a balanced, high-fiber diet; Increased dietary fiber of 25-30 grams / day. High fiber cereal can help reach this goal quickly.

3) Drink plenty of water and liquids (about 2 liters a day)

4) Regular exercise; this helps in relieving constipation, if any.

5) Avoid excessive pressure and straining during defecation. Don't sit for extended periods, limit this time as much as possible.

6) Avoid irritant foods, chillies and hot herbs and substances.

7) Warm sitz baths; this is universally soothing and may help decrease the hemorrhoid size. This is done thrice a day for couple of days and then twice a day (15 minutes each time).

8) Local ointments applied in anal canal which contain xylocaine and vasconstrictors (OTC product).

Read here;

The hemorrhoids should respond to these measure in 3-4 days. If they do not completely resolve in a week or 10 days, it would be time to seek a personal examination by a physician.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Customer: replied 1 year ago.

So can you see internal hemroids fir the out side ,she not complaining about pain or swelling as of yet , and do you bleed when you pass stool most of the time with.them?

And what about the antibiotics?

Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello and welcome,

Antibiotics are not needed for hemorrhoids.

Internal hemorrhoids may occasionally come outside. When they go back inside on their own, it is grade two; if they need to be push by tissue paper; that is grade three and if they remain outside it is grade four hemorrhoids. Grade 3 and 4 may need following;

1) Rubber band ligation

2) Bipolar, infrared, and laser coagulation

3) Sclerotherapy

4) Cryosurgery

5) Laser hemorrhoidectomy

6) Doppler-guided hemorrhoidal artery ligation

7) Anal streching or Lord's stretching

Customer: replied 1 year ago.

No I explained she takes antibiotics for her face ,acne I was just wondering if that contributed to the fact.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Doxycycline may occasionally contribute to constipation. If she needs to strain to pass bowel motion she would require a stool softner or a laxative.

Hope she is doing good now.

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