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It is always advantageous to consult an Ayurvedic doctor directly, in person. There are many differences between Piles, Fistula, Fissure, Rectal Hematoma, Pilonidal Sinus, and Rectal Polyp that are to be considered before deciding on treatment lines. I cannot do all those analysis by e-mails. Hence direct consultation is always better than consulting me online. So, if possible better consult nearby any ayurveda doctor if you are far distance from me unless after taking appointment you can meet me at my clinic after e-mail conversation.