Tuesday, September 21, 2010



1. Medication and diet measures.
2. Schlerosant injection
3. Surgical treatment

First stage and second stage treatment usually with medication and diet treatment, or schlerosant injection, usually do not need surgery.
The third and fourth stage need surgery to have cured. Not infrequently third stage patient can be cured with medication and diet treatment.


Since 1982 the writer treated the piles with broad-spectrum antibiotics, antimicrobial and anti-protozoa[ameba, trichomoniasis, giardiasis], and anti anaerobic bacteria. combined with vitamins and diet measures.
This treatment was based on the writer experience and studied on the references about the cause of piles. The writer temporary conclusion that the basic cause of files was mainly multiple infections and inflammations in the rectum and anus had the long run effects on the mucosa and veins circulations to be the caused of piles.
This temporary conclusion need further research and development for confirmation or evidence.

The drugs of choice and available for above criteria for treatment of piles are:

a. Fasigyn [brand name, generic: tinidazole] 500 mg/tablet once 4 tablets [2 gram] daily for 3 days; or
Flagyl [brand name, generic: metronidazole] 500 mg/ tablet-- once 4 tablets daily for 3 days.

b. Terramycin [brand name, generic: oxytetracycline] 250 mg/capsule-- thrice 2 capsules daily for 5-7 days or
doxycycline 100 mg/capsule twice daily for 7 days.

c, Vitamins: vitamin C 500-1000 mg daily; vitamin A 20 000 IU/tablet once daily; vitamin B-complex 2 tablets daily.

The side effects of Fasigyn or Flagyl are feeling of mild dry and mild bitter taste in mouth during treatment [3-5 days].
Fasigyn or tinidazol, Flagyl or metronidazole are contraindicated in first trimester pregnant women [the research in animal found fetotoxic effect in first trimester but not in women] , safe is safe it can be given or treated in the third trimester of pregnant women for piles or after delivery.
Terramycin is contraindicated for pregnant women because of fetotoxic effects, it can be replaced with spiramycin 500 mg/tablet-- thrice 2 tablet daily for 5 days.

The vitamin B-Complex effects to prevent side effects of antibiotics
and antimicrobial; vitamin A 20 000 IU daily to strengthen the epithelium of the mucous membrane, and vitamin C 500-1000 mg daily strengthen the collagen structure of connective tissue it necessary plays an important role in the laying-down of the new connective tissue which is essential to healing of mucous membrane and better vascular of blood vessel .
Treatment of multiple infections and inflammations combine with vitamin A, B-complex and C may have effects to heal and to paste the lax mucous membrane in piles to sub-mucous and smooth muscle of anus and rectum .
If the piles with bleeding the additional treatment vitamin K 5 mg once per oral daily and Adona [brand name, generic: carbazochrom sodium sulfonate] 10 mg/tablet per oral 3 times daily.
For itching give anti histamine such as Phenergan 10 mg twice daily.

The children dose : Terramycin for children is 20-25 mg/kg body weight in two divided doses, and the dose of
Fasigyn for children is 50-60 mg/kg body weight as single dose.

d. The diet treatment: Mild food or steam food during treatment. Avoid hard food and hot chili and pepper foods in the period of treatment and one month after treatment. After one month period to prevent recurrent piles, advice to the patients can eat mild hot chili and pepper foods and better no hot chili and pepper food.
Additional diet fruit treatment particularly with papaya and pineapple which contain proteinase enzyme such as papain .The action of papain is proteolytic enzyme activated by present of H2S [hydro sulfide] keratin-ase enzyme which catalyze hydrolytic reactions of keratin proteins to end products polypeptide and amino acids. [Source: Philip B. Hawk et al. 1954, p 157, 306, 317].
The portion of these fruits during treatment: papaya one cup 3-4 times daily, the pineapple the same 1 cup 3-4 times daily for 5 days; and then a half cup twice daily of papaya and pineapple respectively for preventive, other fruits are supplements.
The mechanism action of these fruit are not clear, may be the proteolytic and hydrolysis reactions of proteins by papain in the phlebitis of veins, may open the occlusion and better flow of blood in the veins plexus of hemorrhoids.

Since 1982 the writer had patients stage 1, 2 and 3 [no case stage 4] every year , all were healed or relieved; those only 2 recurrent patients due to eat the very hot chili and peppers food.
And after treated with Fasigyn,Terramycin and diet, both patients relieved. The recurrent piles may be because of large hot chili and peppers eaten by the patients caused inflammations of mucous membrane in rectum and anus, which induced piles.

Symptomatic treatment: [continued]

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