Hi,
Noted the history about outside that is prolapsing hemorrhoids for 2 years and discharge and leakage of smelly fluid.
All this indicates that you have grade 4 hemorrhoids. The prolapsed hemorrhoids cause local itching,
dermatitis and thus can cause the discharge as you have mentioned.
I would advise you the following in such a situation:
Grade 4 hemorrhoids are best treated with surgical excision.
Any other treatment is either in evaluation like stappler hemorrhoidectomy or other forms of management.
Hence I would advise you the following in such a situation:
Consult a PRoctologist or a
General Surgeon for per-
rectal examination and ano-proctoscopy.
Get an appointment for surgery after discussion with him about the type of surgery, pre and post-op preparation.
Take laxatives to keep stool soft.
High fiber diet.
Send the sample of stool for lab and if infection is present then a 5 day course of an antibiotic,
metronidazole will help.
Take probiotics.
Have proper followup and care after surgery.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. T Chandrakant,
General Surgeon