Piles

• Internal hemorrhoids: Internal hemorrhoids develop deep inside the rectum and may not be visible to the naked eye. They usually do not cause any pain, but you may notice slight bleeding through your anus.
• External hemorrhoids: External hemorrhoids develop on the outer edge of your anus. They may not be visible in some cases, but in other cases, they may look like lumps. External hemorrhoids cause severe pain and discomfort.
• Thrombosed hemorrhoids: Sometimes, blood clots develop within the hemorrhoid tissue. These are known as thrombosed hemorrhoids. They cut off the blood supply to the rectal tissue, causing extreme pain. If left untreated, thrombosed hemorrhoids can cause severe complications.
• Prolapsed hemorrhoids: Prolapsed hemorrhoids develop when the internal hemorrhoids swell and start to bulge outside the anus. They can cause itchiness, pain, discomfort, and a burning sensation.

It will be fair to say that constipation is the mother of piles.

Every reason that may lead to persistent constipation is a potential cause of piles.

Lately, I have also observed a strong relation between stress induced constipation and piles in myyoung patients of age group 25 to 45 years old. This type of constipation could be triggered by anyform stress. It could be a recent job promotion, moving cities, major event in the family or work placeor exam stress.

Obesity makes a patient more prone to development of piles.

In corporate patients, their poor ergonomics, long sitting hours, vague meal times, inadequate hydration, excess caffiene or smoking makes them top the incidence chart today in metro cities.

Poor hydration and indigestion aggravate constipation.

Depending on the duration and persistence of constipation the grade or stage of piles progresses.

Two main symptoms are Pain and bleeding associated with passing of stools.

As piles are swellings in the anal canal, they add on to the constipation on every straining episode of stool passage. In the initial stages, the straining increases with hard stools, and later even with smoother stools it becomes difficult to completely evacuate stools. These are symptoms of Grade 1 and Grade 2 piles or hemorrhoids.

In Grade 3 hemorrhoids, the piles masses appear while passing stools and reduce after some time post-defecation. In a Grade 4 Hemorrhoids, these pile masses need to be manually reduced. When these pile masses are lying like a bunch of grapes at the anal verge, irrespective of passing stools, then this stage is Grade4+.

Bleeding is usually seen in the initial stages of piles and when they are also accompanied with Fissures.

As the stage progresses from Grade 4, chances of complications like Thrombosis if pile mass increases. In thrombosed piles, the blood in the hemorrhoidal vessel gets clot and the lump appears to be very tender and painful. So much so, that these patients are unable to even sit comfortably for a consultation. This stage is usually a surgical emergency.

Constipation which is the mother of Piles can be adequately managed well with home remedies like increased water intake, soft fibre diet, regularised meal intervals, abstinence from smoking and drinking, and aslo optimum sleep. Ideally, these are preventive measures for piles and also fissures.

These remedies definitely help in the Grade 1 and Grade 2 of the disease. However, they hold little to no value in managing or rather treating the Grade 3 and Grade 4 of the disease.

As piles or hemorrhoids are purely mechanical diseases, their definitive treatment is also surely mechanical, which means they can be treated surgically only and not with medicines. To make this simpler, we must understand that oral area and anal area are the entry and exit of the same tube. Hence, the issues and their treatment is almost always similar. For example, tooth caries can never be treated by applying an ice pack or taking medicines. A dentist has to get into the tooth and address it.

Similarly, grade 3 or 4 piles can never be treated definitely without a procedure. I hope we are clear as to why permanent relief from piles is never seen with medicines. Sooner or later every piles patient needs to get it addressed by a Proctologist.

Currently, there are two modes of surgical treatment of piles. A conventional technique called Milligan-Morgan procedure and second is a minimal invasive technique which is done using Laser and stapler.

In the conventional technique, the hemorrhoidal masses are cut or excised and their feeding blood vessels are ligated or tied with sutures. This requires a longer post-operative recovery period of 4 to 5 weeks as there are some dressings and few weeks of bed rest required for adequate wound healing.

On the other hand, a minimal invasive procedure is done under a day care setup with regional anesthesia only. It may also be called a walk-in procedure.

This laser procedure is done using a diode laser of at least 1470nm. Piles up to Grade 3 can easily be treated by laser within 15 to 20 mins. For piles more than grade 3, a laser-assisted with stapler is used to excise the pile masses entirely. This adds an additional 15 minutes to the procedure time. After a minimally invasive invasive procedure, the patient is fit to be discharged within 4 hours without any dressings. These minimal invasive procedures also involve minimal visits to your doctor as there are no postoperative dressings involved.

In the case of a thrombosed pile mass, a hybrid procedure is the best choice for the patient since it is a surgical emergency. Here, the thrombosed pile mass is excised or removed by the conventional technique, and the rest of the disease is taken care of with Laser and Stapler.

For more details on the Stapler procedure, you may follow us on our YouTube channel. For faster recovery and the least rates of recurrence, minimal invasive procedures of Laser have outshined the conventional technique.

The result of treatment for piles entirely depends on the stage at which the patient chooses to visit their proctologist. The treatment result is usually inversely proportional to the stage at which the treatment is taken. So, the sooner the better!

In around 95 percent of the cases, piles surgery does not cause any complications. However, some patients may experience:

• Urinary tract infection
• Fecal impaction
• Pain and discomfort
• Wound breakdown
• Infection
• Anal stricture

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We understand that each patient is unique, and that’s why Dr. Neha Mutha provides exceptional treatment for piles, fissures, and fistulas all in one place in Pune. If you’re experiencing symptoms of hemorrhoids or piles, please don’t hesitate to reach out to the Best Piles Specialist in PCMC, Pune.

For more information on our extensive treatment options or to schedule an appointment with Dr. Neha Mutha for Laser Piles treatment in Pune, please request a callback. We’re here to address your concerns and provide the care you deserve.