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Hemorrhoids - Symptom, Treatment And Causes

What is Hemorrhoids?

Swollen veins near the lower rectum or the anus are known as hemorrhoids. More than half of all adults experience hemorrhoids or its symptoms before turning 50. They may be external or internal. External hemorrhoids form outside the anus, while internal hemorrhoids form within the rectum or anus. Hemorrhoids can also be called piles. External hemorrhoids can be the most troublesome and are the commonest kind. Hemorrhoids cause severe itches, difficulty in sitting and pain. They are thankfully treatable. Experts aren’t really sure what makes hemorrhoids appear.

Possible factors are:

  • Being strained during bowel movements.
  • Complications during chronic constipation
  • Sitting for long time periods, especially on toilets
  • A familial history for hemorrhoids

What causes Hemorrhoids?

Hemorrhoids may be genetically passed from parents to children. If either of your parents have had hemorrhoids, then you have higher chances of getting them. Constant lifting of heavy objects, having continuous body strain or being overweight can put consistent strain on the body and increase the risks of hemorrhoids. Standing for prolonged periods without taking breaks can also result in hemorrhoid formation. Diarrhea and constant anal intercourse also can increase the risks for hemorrhoids. Pregnancy also increases the chances of developing hemorrhoids. The uterus when it enlarges, presses on a vein present in the colon and makes it bulge. A visual exam of the anus suffices for diagnosing hemorrhoids. For confirming the diagnosis, the doctor might do a separate exam to look for any kind of abnormalities in the anus. This is called a digitized rectal exam. The doctor puts in a lubricated and gloved finger on to the rectum in this exam. If they experience any abnormalities, they might ask you to get an extra test done, known as a sigmoidoscopy. Your doctor will use a tiny camera to look for internal hemorrhoids in a sigmoidoscopy. This tiny fiber optic camera known as a sigmoidoscope is fitted into a narrow tube and is then inserted into the rectum. Using this test, the doctor can get a clear vision of the insides of the rectum so as to examine the hemorrhoid closely. To avoid straining the hemorrhoid, you should avoid putting pressure during bowel movements. Also, try increasing the daily water intake. Drinking sufficient water can prevent the stool from becoming too hard. Regular exercise should be done to prevent constipation. Consuming foods which have a high dietary fiber content can reduce the risks of possible hemorrhoid formation later on. You would notice better bowel movements after proper treatment. Following the doctor’s advice and being regular about certain habits can also help in the overall treatment and prevention of hemorrhoids.

Treatable by medical professional Usually self diagnosable Lab test not required Chronic: can last for years or be lifelong Non communicable
Extreme itching around the anus. Irritation and pain around the anus. Painful bowel movements. Blood leakage after having a bowel movement.

Popular Health Tips

Things To Consider Before Going For Piles Surgery!

M.S, General Surgery, Bachelor of Medicine Bachelor of Surgery (M.B.B.S.), Medicine, Fellowship In Minimal Access Surgery, Fellowship In Laparoscopic & Robotic Onco-Surgery, FIAGES, Fellow in MInimally invasive HPB surgery
General Surgeon, Chennai
Things To Consider Before Going For Piles Surgery!

Piles or haemorrhoids refer to swollen blood vessels inside and around the rectum and anus. Depending on where they are located, they can be classified as internal and external haemorrhoids. Small haemorrhoids can be treated with medication, but surgery may be recommended for larger Hemorrhoids. This is known as a “Hemorrhoidectomy” and involves cutting out the enlarged veins. This surgery may be performed in many different ways.

Preparing for a Hemorrhoidectomy
A Hemorrhoidectomy is typically a one day procedure and does not require hospitalization. The patient will be given instructions that need to be strictly followed before the procedure. These include:

  1. No food should be eaten after midnight on the night before surgery. If any medication is to be taken, it should be accompanied by only a small sip of water.
  2. All makeup and jewellery must be removed before surgery.
  3. The patient may be asked to take a mild laxative or enema on the night prior to surgery.
  4. Talk to the doctor about any medication currently being taken for diabetes, blood pressure, asthma, heart conditions etc. In some cases, the medication may need to be stopped for a few days prior to surgery.

When the patient comes to the hospital for surgery, he or she should wear loose, comfortable clothes with an elastic waistband. Any medication being taken should be brought along. While the patient will be discharged the same day, he or she will not be allowed to drive back home. Hence, the patient must also make arrangements for someone to drive them home.

Surgery Procedure
This surgery can take anywhere from half-an-hour to one hour. After consulting the doctor, the patient will be given a hospital gown and medication through the intravenous route to help them relax. Various devices are attached to the body to track the patient’s heart rate, pulse etc. The patient is then put under general anaesthesia for the surgery. After the surgery, the patient will be kept in the recovery room for an hour. They are then transferred to another room and given something to eat and drink.

Hemorrhoidectomy Risks
This procedure has a high success rate and is considered relatively safe. However, as with any other procedure, there are a few risks involved. Before undergoing this surgery, the patient must be well aware of these risks. They include:

Some patients may also experience trouble passing urine. This is because the pain caused by surgery makes it difficult for the patient to relax. However, there is nothing to worry as these risks can be effectively managed by the doctor.

How To Deal With Hemorrhoids?

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
General Surgeon, Hyderabad
How To Deal With Hemorrhoids?

What is hemorrhoid?

Hemorrhoid (piles) is a condition where the veins in the lowest part of rectum and anus get swollen.

How to deal with it?

Following are the most effective measures to reduce the suffering from the piles:

  1. Placing a towel soaked in cold water on the piles relieves the pain, irritation, and burning around the anus.
  2. Protruded hemorrhoids can be pushed back into the rectum, using a lubricating jelly, while bathing.
  3. A fiber supplement, which includes Metamucil, Citrucel, or Fiber Con, and a fiber-rich food, such as broccoli, beans, wheat, oat bran, whole-grain foods, and fresh fruits, should be included in the diet. Fibrous food softens the stool and makes it easier to pass, thereby reducing pressure on hemorrhoids.
  4. Exercise will help by stimulating the bowel function and by improving constipation. Aerobic exercises, such as brisk walking, jogging, cycling, skipping for 20-30 minutes a day, at least for 5 days per week, should be included.
  5. Do not strain. Straining for the stool leads to pressure on the hemorrhoids and causes worsening of the symptom.
  6. Don’t wait for a convenient time. Immediately pass the stool when there is urging. This stool can back up, leading to increased pressure and will require straining to pass in future. Keep a fixed time for passing stool, such as after a meal, or after waking up, and sit on the toilet seat for a few minutes. This will help to establish a regular bowel habit.
  7. Take a regular sitz bath. A sitz bath is a warm water bath for the buttocks and hips. It helps to reduce itching, irritation, and spasms of the sphincter muscle. A 20-minute sitz bath after each bowel movement, two or three times a day, will help reduce burning and itching after passing stool.
  8. Topical medication, such as creams containing a local anesthetic agent, can be used to relieve the pain. They are applied before passing the stools. Anti-inflammatory home remedies, such as Witch hazel, aloe vera, and a warm bath with Epsom salt helps reduce symptoms of piles.
  9. Using a toilet paper after a bowel movement can aggravate existing hemorrhoids, as wipes which have alcohol, perfume, or irritants cause more irritation and worsens symptom. Use wipes which are medicated, such as wipes with aloe vera or witch hazel.
  10. Stool softeners or fiber supplements help reduce constipation, make the stool softer, and make it easier to have quick, painless bowel movements. Oral painkillers can be used to relieve the pain, such as aspirin and ibuprofen.
  11. When an external hemorrhoid is very painful due to a blood clot, surgery is usually indicated in order to relieve the symptoms.
3426 people found this helpful

Piles - Recovery Tips After The Surgery!

General Surgeon, Faridabad
Piles - Recovery Tips After The Surgery!

Piles or Hemorrhoids is a common condition that can affect a man or woman at any stage of their life. This is not life-threatening but it can be extremely painful and uncomfortable. Therefore, seeking the proper treatment at the right time is necessary. Surgery is one of the best forms of treatment for this condition. This is known as a hemorrhoidectomy. It ensures that the problem does not recur. Recovering from a surgery to remove piles can take 2-3 weeks. Here are a few tips to ensure fast healing.

Take a sitz bath
A sitz bath can help relieve pain and discomfort after a hemorrhoidectomy. This involves filling a shallow tub with warm water and sitting in it. It is important not to add anything to this water. A sitz bath can be taken multiple times in a day in the first week following surgery. The warm water helps relax the muscles and reduces swelling and pain. Once the water cools down, you may follow a sitz bath with an ice pack. This should not be placed in direct contact with the skin and should be held in place for not longer than 5-10 minutes.

Use a handheld shower to keep the area clean
It is important to keep the surgery site clean at all times. However given the sensitivity around the area, this can be difficult especially after passing stool. Using a handheld shower or bidet attachment can make this process easier and less painful. Air dry the area or pat it dry with a soft towel. Do not rub the area as it may damage the skin.

Use medication wisely
Your doctor will probably prescribe painkillers after the surgery. This prescription must be followed strictly as overuse of opioid painkillers can result in constipation. Along with this, a laxative or stool softener may also be prescribed. The instructions given with this medication must be followed strictly. Taking excessive doses can lead to diarrhoea that may, in turn, slow down the healing process.

Eat Right
To prevent constipation and speed up the healing process, the patient must have a well-balanced diet. This should be rich in fibre to enable waste to travel smoothly through the digestive system. The patient must also drink a minimum of 8-10 glasses of water a day. This does not include soft drinks, juices, tea, coffee etc. This keeps stools soft and makes their excretion less painful.

2760 people found this helpful

Piles - Know About Its Types And How to Prevent Them!

F.I.A.G.E.S , MNAMS (Membership of The National Academy) (General Surgery), DNB (General Surgery), MBBS, IAGES
General Surgeon, Delhi
Piles - Know About Its Types And How to Prevent Them!

Piles, another term for haemorrhoids, are swollen blood vessels in or around the anus and rectum. Haemorrhoid swelling occurs when there is an increase in the pressure in the small vessels. Therefore, the vein walls become stretched, thin, and irritated by passing bowel movements, and this is when piles develop.

Types of Piles: Haemorrhoids are classified into two general categories:

  1. Internal haemorrhoids: Internal haemorrhoids are located far within the rectum, and cannot be seen or felt. They are normally located between 2 and 4 centimetres above the opening of the anus. The only symptom is usually bleeding.
  2. External haemorrhoids: External haemorrhoids occur on the outside edge of the anus under the skin, where there are many pain-sensing nerves. Despite the name, external piles aren’t always seen outside of the opening of the back passage.

Symptoms of piles: Generally, the symptoms of piles are not serious. They normally resolve on their own after a few days. These symptoms can also vary depending on the size, position, and grade of the pile. So before discussing the symptoms, let’s take a look at the grades. Grades are nothing but the intensity by which piles occur:

Grade 1: These are small swelling

Grade 2: These are larger swellings

Grade 3: In this case, it hangs out from the anus during bowel movements

Grade 4: In this case, the hanging from within the anus is permanent

The most common symptom is bleeding after going to the toilet or to pass stools. A lump in and around the anus, a feeling that the bowels haven’t emptied completely, watery discharge from the anus, an itchy or sore skin around your anus and pain and discomfort during or after a bowel movement are some of the common symptoms.

Cause of piles: Anyone at any age can be affected by piles. However, they are usually more common in elderly people and during pregnancy. Modern lifestyle, excessive consumption of junk food, stress, and improper eating habits accounts for a majority of anorectal complications, including piles. Diet has a pivotal role in both causing and preventing piles. People who eat high fiber diet are less likely to get haemorrhoids, but people those who prefer a diet high in processed foods are at greater risk of piles. There can be a lot of reasons. However, some of the basic reasons are low fibre diet, prolonged sitting on toilet, indigestion, obesity, diarrhoea, long-term coughing, having a family history of piles, excessive heavy weight lifting, spinal cord injury and lack of erect posture.

Prevention of piles

The preventive measures include:

  1. Eating plenty of fibre-rich foods such as fruits, vegetables, whole grains, nuts, beans, and pulses
  2. Drinking plenty of fluids such as water helps prevent constipation
  3. Avoiding sitting in the same place for long time
  4. Staying active
  5. Simplest one is to avoid fighting the urge

Stapler Surgery For Piles 
Stapling is used to treat prolapsed hemorrhoids. A surgical staple fixes the prolapsed hemorrhoid back into place inside your rectum and cuts off the blood supply so that the tissue will shrink and be reabsorbed. Stapling recovery takes less time and is less painful than recovery from a hemorrhoidectomy.

Small changes in lifestyle can make bowels regular and faeces soft, thereby preventing constipation and piles. There are several lifestyle changes that may be adopted to reduce the symptoms of piles and reduce episodes of aggravated piles in susceptible individuals.

1951 people found this helpful

Internal Haemorrhoids - Best Ways They Can Be Treated!

MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery, FAIS, Fellowship In Minimal Access Surgery
General Surgeon, Mumbai
Internal Haemorrhoids - Best Ways They Can Be Treated!

Hemorrhoids or piles are diagnosed by swelling of veins in the lower part of anus and rectum. Due to swelling, the walls of rectum and anus are stretched and thus become irritated. Hemorrhoids are of two types: Internal and External hemorrhoids.

Internal Haemorrhoids: As the name suggests, the piles are not visible from outside. These are present deep inside the rectum, located above the pectinate line and these are covered with the cells that are present through the rest of intestines. Internal hemorrhoids are normally painless. The first sign of internal hemorrhoids is rectal bleeding. However, straining can push internalhemorrhoid and it protrudes through the anus and this can be painful.

Causes of Haemorrhoids
The swelling of hemorrhoid occurs only when the pressure in the small vessels of rectum and anus is increased and is engorged with blood. The size of the hemorrhoids is also increased. The increased pressure may be due to various factors:

  • Consuming low fiber diet and pushing or straining while passing stools, thus blood vessel pressure is increased.
  • Pregnancy also is a cause of swelling as there is the increased pressure of the uterus on rectum and anus.
  • Sitting for long on toilet also increases pressure.
  • Obesity is also a cause of hemorrhoids.
  • People suffering from diarrhea, both acute and chronic.
  • A person having colon cancer might have hemorrhoids.

Signs and Symptoms of Haemorrhoids:

  • The most common symptoms of hemorrhoids are painless bleeding, itching in anal, swelling and feeling of the presence of lump at the anus.
  • All these symptoms are associated with inflamed hemorrhoid.
  • Inflamed internal hemorrhoid can cause swelling, but is painless as there are no fibers attached to veins above the pectinate line that cause pain. However, passing hard stools can scrape off the thin lining of hemorrhoid, which can cause the painless bleeding.
  • Spasms of the rectum and anal muscles caused by these swollen hemorrhoidscause pain, especially when they are protruded through the anus.
  • Internal hemorrhoids can form a clot or thrombose resulting in severe pain.
  • The presence of has inflammation, stool,and constant moisture and these can lead to itching and burning sensation in the anus among patient of internal hemorrhoid.

Treatment of Haemorrhoids

  • Diet: Haemorrhoids can be treated when individuals consume a fiber-rich diet in order to soften the stools and ease their bowel movements. Fiber-rich foods include fresh fruits, dry fruits, grains, vegetables, and cereals. About 20 to 30 grams per day of fibrous foods is recommended. Dietary fiber will help create bulk in the intestines which will help in softening of stools and ease bowel movement. Supplemental fiber available in the marketincludes psyllium husk, methylcellulose, and calcium polycarbophil. Other recommendations include increased intake of liquids and having stool softeners. Drinking enough water and liquids will prevent stool from hardening.
  • Over-the-counter topical treatment: There are various products available to treat hemorrhoids, such as gels, hydrocortisone creams, ointments, foams, pads, and suppositories.
  • Home remedies: Soaking anus in a warm sitz bath might also help in hemorrhoids for about 10 to 15 minutes per day. One should practice good hygiene and clean anus with warm water while showering. Avoid using soap and dry toilet paper. One can also use a cold compress on the anus.

Minimally Invasive Procedure for Hemorrhoids (MIPH)

Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.

MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised, proximal to the piles and disrupted mucosa is fixed by ‘stapled end to end mucosal anastomosis.

This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30–45 minutes. In case you have a concern or query you can always consult an expert & get answers to your questions!

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Popular Questions & Answers

Sir I am on medications after my piles surgery. Earlier those medicines were helpful for daily stool but now they aren't helping me out in the same. On every alternate day or two I am having stool but it stays hard and cause problems while excretion. Do I need to change my medicines or need to continue with the same? Current medication: orofer xt - 1 daily lesuride od75 - 1 daily gudlax plus syrup - 10 ml daily (before sleep) also, doctor suggested me to drink more and more water but it's not helpful.

MBBS, MS - General Surgery
General Surgeon, Hyderabad
I feel sorry for you, madam without examining you it is difficult to suggest treatment, you have not mentioned when you underwent surgery for piles and was he a qualified surgeon with experience. You have not mentioned if you have pain while defecation. Though doctors routinely prescribe laxatives post surgery for easy evacuation of stool, it so happens the large intestine gets habituated to laxatives on prolonged usage and the dosage or brand of medicine you have been using fails to work effectively as it did initially. Some surgeons tinker with the anal sphincter during surgery for piles when excess tissues are removed resulting in anal sphincter contracture resulting in painful defecation, in such cases repeated anal dilatations may be required. Purely increasing water intake will not solve your problem, you need to eat fruits as a whole, not fruit juice, eat lots of green leafy vegetables, avoid bread and maida roti etc. My suggestion is to visit a senior proctologist/general surgeon/ or gastro intestinal surgeon.
1 person found this helpful

Ihavepiles bleeding with stool I used daflon500 mg foroneweek canitake more daflon tell me time duration further medicine for pain burning itching have external piles.

MBBS, MS - General Surgery, Fellowship of Indian Association of Gastrointestinal Endo Surgeons (FIAGES)
General Surgeon, Meerut
Piles are the swollen veins which can be managed at early stages with diet modification, sitz bath and avoiding constipation, later stages you might need to take injection or under go surgery kindly visit a surgeon and get proctoscopy done.

Is Laser CO2 Surgery painful in treating Sentinel piles? What is the lump sump cost? Which is better, Kharshutra or Laser CO2 for sentinel piles? Please answer all the three questions.

MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
General Surgeon, Varanasi
It's least painful. Depending on the institution it will cost you from 15000 to 50000. I cannot comment on which is better because each of them have their own pros and cons. Hope I answered your questions. Kindly make a personal consultation to me regarding the surgical opinion.

Table of Content

What is Hemorrhoids?

Possible factors are:

What causes Hemorrhoids?

Play video
Fissure And Piles
If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks and do not lead to complications. On the contrary, fistulas, when left untreated, may lead to complications.
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Me Dr. Kulbhushan Bhartiya hun, director & laparoscopic surgeon. Ajj Apko me piles ke bare me kuch btana chahta hun. Piles ke symptoms hain pain, blood from anal, ya fir kuch gantho ka bahar ana hai. Iske mukhye karan galat toilet training hai. Hum bacho ko bachpan me hi train kar dete hain ki jor lga ke potty kren jis s unhe problem hoti hai or vhin se masse banne start ho jate hain. Dusra hmare bhojan ke andar reshe ki kami. Reshe hmare mal bnane or peat saaf krne me maddad krte hain. Aaj kal ke fast food se rehse ki matra kam hoti ja rhi hai. Iske karan bhi bavasir ka nirman hota hai. Tisri kuch liver ki bimariyan hai jiske anadar masse ban jate hain.

Masson se upchar ke lia hum kya kya kar skte hain? Sabse pehle hmari toilet training shi honi chaiye taki jab bhi hume pressure ho, tabhi hum toilet jake apna peat clean kar sken. Dusra hum bhojan ke andar apne reshe ki matra badhayein jiki hum fruits and vegetables se milti hain. Fried foods avoid kren. Fried food se hume constipation ka problem ho skta hai. Iske roktham ke lia hume jyada pani pina hai or hume ye dhyan rkhna hai ki hum jyda se jyada paidal bhi chalen.

Agar hum in sab chizon ka dhyan rkhte hain to hmare masse aage nhi badhte hain. Khood jyada niklne ke chances ho jate hain. Iske lia hume operation bhi krna pad skta hai. Agar hum in chizon ka dhyan rkhenge to hum oepration ki jrurat kbhi nhi pdegi. Masse hmari khoon ke nason ka ek gucha hai. Hum injections se inko sukha dete hain jis se ye thik ho jate hain. Dusre treatment me hum ek band in nason ke guche pe lga dete hain jis se unki blood supply band ho jati hai or ye masse gir ke khtm ho jate hain. Tesra conventional surgery jo hum hath se oepration krte hain.

Usme hum in masson ko pehle bandhte hain and uske baad kat dete hain. 4th latest technique hmari durbin ke dwara hai jiske andr hum mason ko bhi khtm kar dete hain or agar guda ka rasta thoda bhi bahar aa rha hai to vo bhi thik ho jata hai. Agar hum sari chizon ka dhyan rkhen or bachav rkhen or khane me reshe ki matra jyada rkhen and fruits and vegetables jyada khayen to hume operation ki jrurat nhi pdegi. Hume jaise hi iske symptoms feel hon, hume immediately doctor se milna chaiye quki khoon aane se kayi or bhi bimariyan ho skti hain.

Play video
Major Causes Of Piles In Daily Lifestyle
Hello Everyone,

I am Dr. Avaneesh Hasiza. I am a Consultant General and Endoscopic Surgeon at Utkarsh Speciality Clinic in Gurgaon.

So today I am going to discuss about piles or hemorrhoids what we call in medical terms. Piles are inflamed or abnormal veins, dilated veins in the anal canal. In piles, usually the main cause is chronic constipation or there can be many causes. They can be hereditary also. The main cause is constipation. So constipation occurs because whenever there is lack of fibres in the dietary intake, there is inadequate water intake in the body or inadequate what you say lack of fibres in the diet or inadequate water intake so constipation, it causes. It is the cause of piles. So piles can be of various degrees.

There are 4 degrees of piles and the frequency of piles, in the initial degrees we can treat it with medications and the dietary lifestyle modifications but in the higher degrees or when the initial degrees when the medical treatment fails, we have to undergo for the surgical treatment. Surgical treatment of piles, there are various methods for surgical treatment of piles. The conventional surgery as we all know we used to cut the piles dilated veins and remove the piles by the piles mask but that used to leave a large wound in the anal region.

You know that it used to take a long time to heal, so before the treatment one should also mention about the symptoms of piles. Usually patients suffer and complain of bleeding through the rectal region, pain while passing stools. There is mask coming out of the anal region which sometimes regresses itself sometimes it has to be reduced with the fingers and the treatment as I told earlier in the conventional treatment removal of files mask it is a conventional hemorrhoidectomy that used to leave the wounds large phone that takes around a month to heal and it is a concern for the patient that is used to bleed as well as it causes pain and the latest advent of technique of treatment of Piles is stapled hemorrhoidectomy. Indus technique there are many advantages of this dectomy.

We use a circular stapler specialised instrument pph which we used to treat the piles. With this technique there is no wound outside we use the circular stapler Bee removal circumferential strip of main kosa which Cuts of the blood supply of the piles and the piles they shape back to its normal Anatomical position and if any external competitor of piles it means it will regret over a period of 3 to 6 months. The advantages of this technique there is minimal or no pain after the surgery there is minimal sometimes there is no bleeding after the surgery and the patient is very comfortable and then go back to his normal routine activities in a few days and the hospital stay for this surgery usually one day the patient can be discharged on the same day itself.

And after the surgery there is not a long-term medication required and the patient is very comfortable and can go back to the normal work and there is no difficulty in passing stool after the surgery itself.

In case you feel any difficulty are you want to clarify things you can connect with me. I am Dr. Avaneesh Hasiza you can connect with me at Utkarsh speciality clinic which is located in Sector 46, Gurugram, behind Guda market.

Play video
Briefing On Piles
Hi everyone,

I am doctor Vaibhav Kapoor. I am a consultant laparoscopic and laser surgeon at Max hospital, Gurgaon.

Today I will be discussing about new modalities in the treatment of various Anorectal conditions like piles, fissure, fistula these are one of the most common problems and with the large population you know suffering from these conditions. People generally who suffer from these conditions of Piles and fissures fistula complain of either bleeding in the rectal area which is generally fresh before or after they pass stool or they have severe pain while they pass stools and the pain generally lasts for few hours after they pass stools or they complain of some pus discharge in that region and also swelling in the anal region. So we mainly discussing the new modalities in the treatment of Piles but before that, I just give u small note on what actually these conditions are. Anorectal conditions can be classified as piles, fissure, fistula these are one of the most common things, so, what are piles? Piles are basically inflamed veins or tissues in the lower rectum and anal canal, there are various causes but the most common cause of it is chronic constipation, why does it happen lack of fibers in the food, eating junk food you know not taking a lot of water they are one of the primary causes. Then in women especially during pregnancy they can have piles, symptoms are like I told earlier are mixed these condition either patient can have fresh bleeding when they pass stools or they can have pain or some sort of the swelling in the anal region. So diagnosis is very simple the surgeon just needs to examine your lower rectum and he can come on to the diagnose it. So how do we treat it, the conventional treatment as everybody knows was open surgery for piles so it led to heavy wounds, dressing for at least a month, people not used to go out fearing that wounds will discharge. Now with the help of new technologies and with the help of laser what we are doing is the laser ablation of ambroid and fissures, it s the diode laser and there are great advantages up over conventional surgery. It's a simple 15 to 20 minutes surgery almost painless and there were no dressings to be done in the postoperative period and patients are generally discharge on daycare. So I will be now discussing about how with the help of lasers we treat piles, so laser energy is basically delivered to the pile base marks and you know it causes instant shrinkage of the piles and then over the period of 10 to 15 days the entire pile marks should end. The advantages of using laser is it's a simple 10 to 15 minute surgery, done under either general anaesthesia or initial anaesthesia, patients are generally discharged during a daycare or they kept for maximum 24 hours, post surgery you will just your antibiotic and pain Killers that s it, it's relatively painless surgery as compared to open, there are no wounds in the area, there no dressing to be required and even start as early as you know from next day your all routine work. Post surgery you generally gave some sort of diet chart which will help you by constipation and some pelvic floor exercises will be taught to you which will help you prevent constipation in long run. Another question which happens is that after the surgery piles generally reoccur, later with conventional surgery the chances of reoccurrence was there with the advent of laser surgery and the minimal tissue damage the chances of reoccurrence have gone down, that is one of the most advantageous things if you are with a laser.

And secondly post-surgery care which we generally don't do so that will be given to you which will help you in avoiding constipation in long run and hence these things don t reoccur and to get any further information you can contact me through Lybrate. You will be having entire details about how the laser surgery works and you can read about piles and fissures on that.
Play video
Piles or Hemorrhoids
Here are cause,symptoms and treatment of Piles or Hemorrhoids

"Hi friends! Nice to be with you through this wonderful medium called Lybrate . Today I am here to discuss with you one of the most common, irritating and nagging problem which we in common language call as Piles or in medical terminology we call them as Hemorrhoids .

Bleeding Piles or Hemorrhoids is one of the most common problem in our society. It has evolved, the presentation has changed and the number of patients getting effected by this problem continues to be very high. It effects males as well as females in equal number. Early age group and late age group, both are included in this irritating problem. The main issue with this particular disease is that a lot of people in our country still feel a little bit inhabited and ashamed to discuss this problem.

Now what are basically Hemorrhoids or Piles? They are basically nothing but Venus or small veins which are there in our rectum and anal canal, which over a period of time for some reasons, known and unknown, become prominent, dilated thin walled and then with every episode of passage of stools there is bleeding. One of the most important symptom, bleeding, whenever it occurs more than once or twice is never to be ignored because we could be dealing with what we call as Hemorrhoids. Classically, Hemorrhoids never cause pain, it will be a painless bleeding and if it is associated with pain then we must keep an option of fissure in association with Hemorrhoids.

Fissure is nothing but a cut onto the tracheal wall or the anal canal wall, which at every time of passage of motion will produce pain, bleeding and after that some variable amount of burning sensation. This problem does not need high funda stuffs like CT scans and MRI, we can do away with a diagnosis of Hemorrhoids and fissure with a good clinical examination. In some patients with extreme age groups we do recommend Sigmoidoscopy or a Colonoscopy which are basically an outpatient endoscopic tests. No higher level of investigations are required in these particular patients.

Well, the treatment of Hemorrhoids varies. It comprises of some medical treatment in terms of medication tablets, syrups, other things, and surgery. Small Hemorrhoids what we medically call them as Grade-1 Hemorrhoids, rarely require treatment. Grade-1 and Grade-2 Hemorrhoids, they may settle down with medical treatment in terms of some syrups which reduce constipation, antibiotics and some analgesics. The remaining patients of Grade-3 and Grade-4 definitely need operation.

Surgery can be done in various methods. There are newer techniques, one of the popular newer technique is what we call as a stapled Hemorrodectomy and then there are conventional techniques. In our mammoth experience of last ten to fifteen years, irrespective of technique if the surgery is performed safely in experienced hands, it rarely produces symptoms again, recurrences are less and complications are fewer. I recommend all the patients who are in regular working hassles not to delay these symptoms. Try and see at which level your hemorrhoids are and choose an appropriate treatment from a good competent doctor. As I have said earlier and in many instances, simple diseases become complicated when they are ignored or they are wrongly treated.

My sincere request to all of you is, do not ignore bleeding per rectum, have a quick correct diagnosis through a good doctor and don t get unnecessary jitters by listening to the word surgery. Hemorrhoid surgery has become safe and is very very complication free in safe and experienced hands. Thank you. "
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