Dr. Prashant Saxena

Are you feeling an excruciating pain in the anal region? Is there a lump around the area that you can feel? Commonly called Piles, hemorrhoids, is a phenomenon where the blood vessels are inflamed or expanded in the anal canal. Veins in and around the anus and rectum are comparatively weak than the arteries which are quiet intense. This is because the walls of the veins are pretty thin and pain or discomfort arises when there is too much pressure on the walls. There are two kinds of Piles the internal piles and the external piles; the discomfort and severity depend on the kind of piles you are suffering from.

Causes behind it
The causes of hemorrhoids are not certain and anyone can get affected by the condition. It is more prevalent in elderly people and pregnant women. Sometimes, the condition is also hereditary, so if your parents or grandparents suffered from piles, there is a possibility that you may develop it too. When the veins in the anal region are subjected to pressure, the veins swell causing painful hemorrhoids.

The common symptoms associated with the condition are:
- Bleeding from the anus
- Painful lump or swell near the anus
- Anal itching
- Tenderness or pain during bowel movements
- Mucus Anal discharge

Treatment options for piles
In few cases, the Hemorrhoids can be treated with home remedies like a change in diet, warm sitz baths, and avoiding foods that may lead to constipation. For hemorrhoids of the first, second and third-degree, medications, home remedies and manual methods are preferred approaches. However, when the condition persists for an extended period with severe pain it is best to consider your physician.

The piles can be treated with:
- Injection or sclerotherapy: Treats internal hemorrhoids
- Banding: Treatment for prolapsed hemorrhoids
- Coagulation: Treatment using laser
- Surgery: Opted for in severe cases of hemorrhoids

Surgery is suggested when no other remedies for piles have responded. In the case of prolapsed hemorrhoids, or the fourth degree and higher degree, surgical methods need to be implemented. In common, surgery is deemed as the last option for piles treatment. Piles surgery is prescribed particularly by the surgeons in the situation where pain becomes unbearable.

The surgical treatments
Hemorrhoidectomy: This is the surgery done to remove piles. The physician performs a few minute cuts around the anus to remove them away. The area which is under operation is put under local or general anesthesia. Hemorrhoidectomy is often a procedure for the outpatient case, and you are typically discharged on the same day itself. The patient usually takes about two to three weeks, to recover fully but then it can even take as long as five to six weeks to get back to normal pain-free life again.
PPH: Another surgical method is PPH. It is also known as stapled hemorrhoidectomy. In this surgery, the physician uses a device which looks like a stapler to reposition the pile and struck off their supply of blood so that they eventually shrink and die out. This surgical procedure is less painful than traditional hemorrhoidectomy as it removes hemorrhoid to where there are fewer nerve endings, so it hurts less. There will be faster recovery, few or no complications, minor itching, and bleeding.

Laparoscopy is used to diagnose a number of ailments such as ovarian cysts, endometriosis, and pelvic inflammatory diseases to name a few.

It is a type of surgery, which involves the usage of small tubes, surgical instruments and video cameras for operations through small incisions or cuts in your body.

Even though laparoscopy is a very popular form of surgery, there are quite a few myths associated with it, which are:

1. Myth: If you've undergone multiple abdominal surgeries in the past, you can't opt for a laparoscopy: The truth is that you can go for a laparoscopy even if you've gone through multiple surgeries previously, irrespective of the location or size of the previous incisions. This is done through the use of a special instrument, called a microlaparscope that enables safe entry into the abdomen of the patient.
2. Myth: If you're overweight or underweight, you can't undergo a laparoscopy: No matter if you're obese or too thin, you can still undergo a laparoscopy as the tools used for this surgical procedure are available in different lengths and sizes, and can be adjusted as per the body type of the patient before the incision is made.
3. Myth: The images taken through a laparoscope are of poor quality: This is not true. In fact, the visuals obtained through a laparoscope are clearer and much more accurate when compared to those obtained via an open surgery. The visuals of a video laparoscopy provide a detailed magnification of even those parts of the area that are inaccessible by the human eye.

Though different people experience the surgery differently due to difference in health conditions, there are some points everyone should know about a laparoscopic surgery.

1. The problems that laparoscopy addresses: Conditions like ectopic pregnancy, endometriosis and pelvic inflammatory disorders are generally treated using laparoscopic surgery. Moreover, laparoscopy is also used to remove the gallbladder, appendix, patches of endometriosis or detect adhesions, fibroids and cysts. Also a biopsy of the organs inside the abdomen can be done through laparoscopy.
2. The duration of your stay in hospital: Usually performed on an outpatient basis (release on the same day as the surgery), a laparoscopic surgery may require you to stay overnight at the hospital if your condition requires a complex or lengthy surgery. Moreover, if the doctor feels that a bowel resection or partial bowel resection needs to be performed, you may have to stay at the hospital for a few days.