Do you have any pain in the anal region ? While passing stoolsFor hours after stoolsThrough the dayNone
How often do you bleed from the rectum?
DailyOccasionallyOnly when the stools are hard
What is the consistency of your stools? NormalHardOccasionally Hard
How are your bowel habits?
Is there a pile mass
Does the pile mass
Come out with the stools and goes in after stoolHas to be pushed in with handsAlways remain outside
Is there any itching in the anus?
How often do you exercise?
DailyMore than once a dayMonthly onceNever
Have you got any investigations done? (If yes, then please mention the details of the reports in the ‘more symptoms’ column at the end of the questionnaire)
Are you already a patient with Dr.Manoj's Homeopathy? If yes, then give your Registration Number in the text box.
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