Hi doctor, I am facing swelling in anus area which is not getting shrunk even after trying some medicine and cream for piles.
Hello, Welcome to ilciniq.com. Good day. I have reviewed your history and picture that you have uploaded (attachment removed to protect patient identity). It seems to me a sentinal pile. They are not actually pile (hemorrhoids/ blood sac) but a anal fissure that has been present for so long and leading to bulging appearance resembling a pile.  Well having said that, the treatment you are on is majorily ayervedic but there are avaialble allopathic medicines which can be used instead. I would give you some treatment but I want that you should be examined in person by a local general surgeon, if any need of surgical removal of this. Otherwise at moment take following treatment.  1. Ispagol Husk 2 tsp/ daily with water irrespective of if you have soft stools or hard stools. Fibre has to do with many other things in your gut besides just stool softening effect.  2. Tablet Ciprofloaxcin 500 mg twice daily for 5 days.  3. Tablet Flagyl 400 mg thrice daily for 5 days (can cause some gut upset and mettalic taste in mouth but fairly low side effect profile).  4. Sitz bath. Put approximately 5 ml of dettol or any antiseptic and put in bath tub filled almost half with tapid water and at least try it 3 times a day.  5. Keep your area clean near your bottom.  6. Remove hairs.  7. Reduce weight. Increasing weight would impair your defecation (stooling) mechanism and that would abnormally high presure over your bottom. This worsens anal fissure in long term. Let me know in one week time if symptoms improve.