I've been diagnosed last year of bile reflux but until know…

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Your symptoms as you understand are due to hemorrhoids.

Endoscopy last year has ruled out any sinister so do not worry at all.

In your age group hemorrhoid are the commonest cause of these symptoms.

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 help speed bowel movements and decrease strain. 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; 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, chilies, and hot herbs and substances.

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

8) Local ointments applied in the anal canal that contains lidocaine and vasoconstrictors (OTC product).

I hope your symptoms resolve soon.

I would be happy to assist you further if you need more information.

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