Hello doctor, I had an anal fissure six months ago for which the doctor prescribed me Ciplox TZ and SN 15 Plus tablet six days course along with Duphalac Fiber. This cured the fissure and I was having no issues with the bowel movement. Just recently, I did have a slight swelling in the upper lining of my stomach for which I have been taking Pantoprazole as prescribed by the doctor. The swelling or bloating has been much better than before. But I am facing a problem with hard stool each morning due to which I have pain during bowel movement and chance of anal fissure recurring. My questions are:  Is it okay that I take one more course of Ciplox TZ and SN 15 Plus along with the current Pantoprazole medication to take care of the anal fissure relapsing?   Could this be IBS-C (irritable bowel syndrome with constipation)? if so, what is the medicine that has to be taken?  I have heard ayurvedic Dhouti-Yog tablets are good to produce softer bowel and relieve constipation which in turn can stop the fissure from coming back.
Hello. From what you have mentioned, you have IBS-C (irritable bowel syndrome with constipation) and hard stools. There is no need to take Ciplox TZ (Ciprofloxacin and Tinidazole) and SN 15 Plus (Diclofenac and Serratiopeptidase) again. I suggest you drink plenty of fluids plus fiber-rich diet. I suggest you take Senna tablets before bedtime as a laxative. Colvac (Sodium Picosulfate) twice per day for colics and tummy distension. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Follow up is required. For more information consult an internal medicine physician online -->