Decade old piles, fissures - Any advice or recommendations?

There is one over the counter med known as Softolax SF (equivalent to Softovac SF), SF stands for sugar free. 🙂🙂🙂 It is an Ayurvedic med prescribed often by allopathic docs. It has your Psyllum husk(isabgol), arhad daal, sena and Mulethi. I think it can do your job. Instead of having em in the night, have it in the afternoon at 4/5pm. 🙂🙂🙂 Lactifiber is a slightly costly med which has Lactitol (70%) and Isabgol (30%). These meds are over the counter laxatives. If you have exceptionally hard stool contact a doc. They ll mostly prescribe a PEG + electrolytes/ Liquid Paraffin + milk of magnesia based laxatives. Psyllum husk adds bulk to the stool, PEG and latter work by principles of lubrication n osmosis. Examples Looz PEG and Cremaffin(Paraffin + milk of magnesia). Those are OTC drugs. If constipation becomes a bit severe then you might need Cremaffin Plus/ Lactihep Plus. These are prescription only drugs and have Sodium Picosulfate. It is a contact stimulant. Another example of contact stimulant is raw castor oil. They are habit forming ones. In extreme cases suppository n enemas will be prescribed. Pruease etc are also prescribed.

Your case!

Consult a doctor. And you can try any of the above OTC drugs. Softolax/Softovac/Lactifiber are the safest ones. Softolax/vac are to be taken in the afternoon for the best results, lactifiber is the night only thing. Cremaffin is taken after dinner in the night. Overdose can cause diarrhea. So, it is still better to consult a doc. And your constipation will be a history. Cremaffin Plus, pruease etc are not to be taken without prescription n advice of a doc. Those are risky stuff. 🙂🙂🙂🙂

@batguy143 @mas143forever @MSDfan

Edit: Surgery stuff. If anal sphincters have gone weak then you will suffer from incontinence. Stool will leak out. 🙂🙂🙂 In your case maybe he meant anal stenosis. Anal opening becomes narrow and stool does not pass easily. Surgery will fix the issue. But if constipation returns spincters will get damaged again. If fissure happens and surgical procedures are opted then fissurectomy/ Lateral internal sphincterotomy will be done. There are side effects like incontinence etc. If constipation happens it will happen again. 😒😒😒

Edit 2:

not feeling like fully evacuating can be a sign of an internal hemorrhoid. Visit a general surgeon/proctologist for further analysis. .   

In this modern world , due to sedentary lifestyle, eating habits and inactive activities people are getting these kinds of diseases on large extent.

Also,

I don't understand why people avoid surgery and keep growing the ailment for decade and live this precious life with discomfort and pain.

By avoiding surgery last decade , you have got

1) full of discomfort and painful life.

2) Pelvic floor almost damaged which primarily helps supports excretory system and healthy sexual functions.

Current best solution:- 

1) Go to proctologist ,get anoscopy done , he will analyse the condition and will plan surgery accordingly. Follow his advice and get the surgery done asap.

2) Post surgery.... learn about how to keep constipation away...have a permanent share of fiber intake of fiber rich diet in your daily eating routine.

3) For pelvic floor muscles , Go to physiotherapist specialised in Pelvic floor muscles training. This will improve your PF muscles upto some extent which will help you having controlled bowel movement, voiding as well as good sexual functions.

Btw what's your age?

I'm a medical doctor & won't comment on alternate medicine but in my personal opinion I don't suggest that, particularly as your condition is already getting bad.

Internal haemorrhoids can cause pain while passing stool, thereby signalling the mind to stop the defecation process....this can cause/ feel as constipation or incomplete emptying.

You should get the surgery done for now if so advised by your doctor. It can recur but if you follow a healthy lifestyle, the chances are much reduced - stress management, good proper sleep, healthy balanced diet, regular moderate exercises - these have to be followed by everyone, but when you have certain medical condition, it becomes imperative to be strict with these.

me too facing bleeding piles,its there alternate to surgery or how is laser surgery?