Incidence of PILES

As per global data market incidence of piles is 20% of the total population & Research Marketing suggest 40% of Population will have hemorrhoid.

1 - 2 out of 10 patients need surgery depending on the degree of hemorrhoid,
30% - 40% of patients take self medication.

REMAINING 30% - 40% go for prescribed medicines and REMAINING 20% FALL IN THE CATEGORY THOSE WHO REQUIRE LASER SURGERY

PILES (HAEMORRHOIDS)

Piles is a condition where the vessels over the anal canal gets dilated and over a period of time starts bleeding and starts prolapsing outside.

Causes of piles:
1) Genetic cause
2) Spicy food
3) Constipation
4) Unhygienic food habits
5) Frequent and persistent travelling (Drivers)

Stages of piles:

There are four stages of haemorrhoids. Usually 1st and 2nd degree are asymptomatic. The 3rd and 4th degree present with bleeding and prolapse. The stages are explained below.

PILES (HAEMORRHOIDS)

Treatment:

The advanced treatment for haemorrhoids is Laser treatment which causes shrinkage of pile mass and which stops the presentation of bleeding.
This laser procedure takes about 5 – 10 mins and has very less post operative pain in the patient, compared to the conventional surgery.

FISSURE – IN – ANO:

Fissure is the most common presentation by the people, who present with pain in the anal region. Fissure is nothing but a crack in the anal canal, which causes spasm and pain with bleeding.

Causes :
1) Intake of Spicy food, especially sea food
2) Constipation
3) Frequent travel
4) In women immediately after delivery

Types:

1) Acute fissure
2) Chronic fissure

FISSURE – IN – ANO:

Acute fissure:

Usually presents within 1 or 2 days and presents with pain, which is usually treated medically with antibiotics, pain killers and laxatives.

Chronic fissure:
In this condition, the fissure occurs frequently, which causes scarring and does not heal on medical treatment, and they need laser surgery.

Treatment:

Laser fissurectomy gives an excellent relief and procedure takes about 5 minutes.

PERIANAL ABSCESS:

Perianal abscess is a condition, in which the patient develops sudden pain and swelling with fever in the perianal region and they may have urinary complaints. If the abscess is big enough, the abscess causes too much of discomfort, and the perianal abscess bursts itself, if it is a small abscess. If the abscess size is large, we have to drain the abscess under local or spinal anaesthesia. The most dangerous is when the abscess ascends upto the scrotum. There is a dreaded creeping infection caused by a bacteria called E. Coli and the patient presents with Fournier’s gangrene. Due to this severe infection, the patient might go into septic shock which is a dangerous situation.

20 % of the patients with perianal abscess, land up in this condtion, especially, if the patient is a diabetic. Usually, this perianal abscess goes into single tract or multiple tract fistulae.

Treatment:

Incision and drainage of the abscess

FISTULA:

Fistula is a sinus, or a tract in the surrounding area of the anus, in which the external opening gets connected to the anal mucosa after the perianal abscess heals. Usually the person affected with fistula complaints of discharge from perianal region which often forms a bubble like small abscess, which burst itself and again after 2-3 months, they have the same complaints.

Types of fistula:

1) Low anal fistula
2) High anal fistula

FISTULA:

High anal fistula
1)Inter sphinteric
2)Trans sphinteric
3)Extra sphincteric
4)Supra sphincteric

Treatment:

Fistula is one of the most complicated diseases. For this we do the latest microlaser treatment, in which we introduce the laser fibre inside the tract, and burn the complete tract, which usually takes 10 – 15 mins, and which heals completely in 15 – 20 days time.

FISTULA:

Treatment:

Advantage of laser is if the patient goes through the usual surgery of lay open of fistula, where the fistula is cut and lay open. So it is usually painful and the healing time is between, 1 ½ to 2 months. Whereas in this laser technology, it is absolutely a painless procedure , and the patient recovers faster and goes to routine work as early as possible.

Role of Laser in recurrent fistula-

Recurrent fistula is nothing but failure of fistula surgery done in which the fistula recurs again. In this recurrent fistula there is a condition called high anal fistula, which is absolutely inoperable by surgical procedure, because of the risk of incontinence of stools. For such cases , we do microlaser surgery, which gives 98% success in recurrent fistulas.
So whoever has recurrent fistulas, complex fistulas can contact us confidently for best results.

PILONIDAL SINUS:

PNS is similar to fistula but the site of this sinus tract occurs at the beginning of natal cleft, where the spines end. Such patients will present with discharge from the sinus area, which causes discomfort.

For this condition, we do a procedure called pilonidoplasty, in which we do a microlaser treatment, for complete cure of PNS.

RECTAL PROLAPSE:

It is a condition, where there is a decent of the rectal mucosa, as a whole through the anal canal. Such patients present with a mass coming out. Whenever he passes motion, he pushes the mass into the rectum.

Causes :
1) Genetic – occurs from childhood
2) IN adolescence, it occurs due to chronic cough, chronic straining, lifting heavy objects.

Treatment:
In case of mild prolapses, there is a procedure called, Thiersch stitch.
In this procedure , we encircle the anal canal externally with a non absorbable suture material which is left upto 2 – 3 years, depending on the patient and removed once the symptom is resolved completely. In case of severe prolapse, there are 2 types of surgery.
1) Open abdominal rectopexy
2) Laparoscopic rectopexy

RECTAL PROLAPSE:

Open abdominal rectopexy:
We open the abdomen and the sigmoid colon is fixed to the sacrum, whereas in laparoscopy it is a key hole surgery through which the mesh is placed over the sigmoid colon and fixed to avoid descent.