instruction: hello doctor I am 37 years old I had a problem with bleeding in stool so I consulted a doctor and he said it is hemorrhoids he gave me sitcom 100 my for one month I have taken this medicine and blood is not coming now but I have constipation and I took organic psyllium but did not get any benefit please advise me on what should I take to get a normal stool and my 5 year old girl sometimes complaints for stomach pain I consulted the doctor but he gave only pain relief syearup but she did not have any benefit please recommend any test to know the actual problem
output: hi in case of rectal bleeding there are two possibilities one is sous solitary rectal ulcer syndrome this is an ulcer formation in the rectum due to chronic constipation this causes bleed another one is hemorrhoids I think you have sous that can be easily treated by ispaghula and diet modification we do not do any investigation for this until constipation gets treated and it will not respond the problem of hemorrhoids is common in the adult age group constipation is among the one of the cause other risk factors are alcoholic liver disease and rectal carcinoma for constipation we give isabgol methylcellulose that is a bulk forming agent along with this you need to take a high fibre diet and plenty of water if you have hemorrhoids then in early stage exercise can benefit you there are two types of exercise one is to decrease your weight if it is excess more than 80 keg second is to do anal exercise in the form of anal contraction for five minutes every hour controlling constipation will also decrease your hemorrhoids regarding your daughter I think she had constipation you should note the duration of sitting in the toilet and that is more than five minutes in case of constipation and about straining during defecation or passing hard stool if she has constipation then she needs treatment her pain will subside after treatment for this she also does not require any investigation you should tell about her height and weight if it is abnormal then she requires investigations advice follow as per discussion for you provide details about your daughter give her tablet albendazole 400 once only review with details