Piles or Haemorrhoids Treatment in Hadapsar, Pune

Piles (haemorrhoids) are the swelling (lumps) inside and around bottom (anus). There is a network of small veins (blood vessels) within the lining of the anal canal. These veins sometimes become wider and engorged with more blood than usual. The engorged veins and the overlying tissue (support tissue, elastic fibers) may then form into one or more swellings, this is called as piles.

Piles, also known as haemorrhoids, are swollen veins in the anus and lower rectum, similar to varicose veins. They can develop inside the rectum (internal haemorrhoids) or under the skin around the anus (external haemorrhoids).

Common causes include straining during bowel movements, chronic constipation or diarrhea, prolonged sitting on the toilet, obesity, pregnancy, and a low-fiber diet.

Piles Treatment Specialist in Wanowrie, Fatima Nagar, Kondhwa, Undri, Manjri & Hadpsar

What is the main cause of piles?

Piles are swollen blood vessels. It’s not clear what causes them.
Things that make piles more likely:

  • Chronic constipation (irregular stool habits),
  • Chronic diarrhea,
  • lifting heavy weights,
  • Pregnancy,
  • Straining when passing a stool.

When to suspect piles?

  • lumps/swellings around your anus
  • Pain occurs during the passing of a stool
  • Itching/burning inside or around the anus
  • Bleeding while passing stool
  • After passing a stool, a person with piles may experience the feeling that the bowels are still full.

Piles sometimes may present in a more severe condition. This can include:

  • Excessive anal bleeding, which may lead to ANEMIA.
  • Severe pain
  • Infection
  • Anal fistula( channel is created between the inside of the anus and the surface of the skin near the anus)
  • Strangulated/ thrombosed hemorrhoid.

Treatment of Piles

Many people have piles, but the symptoms are not always obvious. They often get better on their own after a few days. If symptoms of piles are not subsiding, then only may require further treatment. Treatment usually depends upon the grades of piles.

  • Grade I: There are small inflammations, usually inside the lining of the anus. They are not visible.
  • Grade II: Grade II piles are larger than grade I piles, but also remain inside the anus. They may get pushed out during the passing of stool, but they will return unaided.
  • Grade III: These are also known as prolapsed hemorrhoids, and appear outside the anus. The individual may feel them hanging from the rectum, but they can be easily re-inserted.
  • Grade IV: These cannot be pushed back in and need treatment. They are large and remain outside of the anus.

External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops, as the blood clot can block the flow of blood. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

Internal piles are normally located between 2 and 4 centimeters (cm) above the opening of the anus, and they are the more common type.

External piles occur on the outside edge of the anus.

External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops, as the blood clot can block the flow of blood. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

  • Grade 1- Usually medication and lifestyle modification will suffice for early piles.
  • Grade 2- Along with medicine & lifestyle modification, sometimes patients may require office procedures or LASER.
  • Grade 3 – Usually requires Minimal invasive procedures like LASER.
  • Grade 4- Minimal invasive procedure (LASER/PPH) or Invasive procedure(Open surgery).

  • Rubber band ligation: a band is placed around your piles to make them drop off. It’s an office procedure.
  • Sclerotherapy: a liquid is injected into your piles to make them shrink
  • Electrotherapy: a gentle electric current is applied to your piles to make them shrink
  • infrared coagulation: an infrared light is used to cut the blood supply to your piles to make them shrink
  • LASER: – laser is extremely useful in grade 2, grade 3 & selected grade 4 piles.

You’ll be awake for this type of treatment, but the area will be numbed.
You should be able to go home on the same day.
If these treatments do not work, you may need surgery to remove your piles.

A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. It causes dematerialization, shrinkage, and fibrosis of pile mass.

  • Very minimal pain
  • One day hospitalization, early return to work possible
  • Very less post-surgery rest
  • No stitch, (nothing is excised, so cushions are maintained)
  • Internationally accepted treatment (USFDA-approved treatment

  • PPH( procedure for prolapsed hemorrhoid): this is also a painless procedure, in this procedure, prolapsed piles are excised.)
  • Stapled haemorrhoidopexy: your piles are stapled back inside your anus
  • Haemorrhoidal artery ligation: stitches are used to cut the blood supply to your piles to make them shrink
  • Open surgery (Haemorrhoidectomy): your piles are cut out

You’ll usually need to be asleep for this type of treatment and may need to stay in the hospital for more than 1 day. In open surgery may need to stay longer.

Best Hemorrhoid Treatment in Pune

About Dr. Abhijit Gotkhinde – Piles Treatment Specialist in Hadapsar, Pune

Dr. Abhijit Gotkhinde laser specialist surgeon in wanowrie hadapsar

Dr. Abhijit Gotkhinde

Consultant Laparoscopic, Robotic & Laser Surgeon
MBBS, DNB (GEN SURGERY), FMAS,
FIAGES, Fellow in Adv lap.

Dr. Abhijit Gotkhinde is one of the Qualified Laparoscopic, Robotic & Laser Surgeon in Hadapsar, Pune. He believes in delivering the most authentic and top-class services in Piles, fissures, Fistula Treatments also Hernia Treatments like Epigastric Hernia, Umbilical hernias, Epigastric hernia, Inguinal hernia, Femoral Hernia. He is the best Appendix doctor in Hadapsar, Pune.

He has extensive experience in GI & Colorectal surgeries. He has a special interest in Laparoscopic/Robotic surgery (cholecystectomy, Appendectomy, Hernia, Hysterectomy & Hiatal surgery) and minimal access to proctology surgery. (Piles, fissure & fistula).

Various types of Hernia occur in people. These hernias types include hiatus, incisional, and umbilical hernias. Symptoms are present in about 66% of people with Groin Hernias. So many treatments can be done for various Hernia Treatment within Laparoscopic/Robotic Surgery Treatment. After trying various methods without complete information and knowledge many people fail to achieve the desired Laparoscopic/Robotic Surgery or Laser Surgery for Hernia and Piles Treatment.

FAQ’s

They may be no more than the downward sliding of anal cushions associated with gravity, straining, and irregular bowel habits.

  1. Bleeding per rectum(from the anus)
  2. Mucosal discharge(thick watery)
  3. Rectal fullness when piles are large
  4. Severe pain due to infection or thrombosis or necrosis

The diagnosis is based on history, physical examination, and endoscopy.

  • Grade l: Internal hemorrhoid bulges into the anal canal during bowel movements(passing motions).
  • Grade ll: Internal hemorrhoid bulges from the anus while passing stools, then goes back inside by itself.
  • Grade lll: Internal hemorrhoid bulges from the anus during bowel movements and must be pushed back in with a finger(by patient/surgeon).
  • Grade lV: Internal hemorrhoid protrudes from the anus all the time which can’t be reduced back into the anal canal

A. Medical management

1. High fiber diet(fruits, vegetables, etc)
2. Adequate hydration(proper intake of water)
3. Stool softener (in case of constipation)
4. To decrease the time spent on the toilet

B. Surgical Management

Usual treatment options :
1. Change of diet and lifestyle (Grade I)
2. Lotions, medicaments, ointments (Grade I)
3. Rubberband, sclerotherapy, infrared coagulation (Grade I + II)
4. Closed surgery: Stapler Hemorrhoidopexy (Grade III)
5. Open surgery: Milligan-Morgan, Parks (Grade III + IV)
6. Hemorrhoid Laser Procedure(all grades).

1. Couple of days to a week in the hospital
2. Pain for 7-10 days
3. Postoperative bleeding
4. Infections
5. Abcess
6. Problems with sitting
7. Open wounds need 4-6 weeks to heel
8. Necessity of taking baths

  • Minimally invasive laser therapy of hemorrhoids
  • Controlled hemorrhoidal shrinkage
  • Very good hemostasis
  • Maximized preservation of continence
  • Small wound sizesLaser HemorrhoidoPexy (LHP)
    Also known as LaserHemorrhoidoPlasty
    This approach is used for the treatment of hemorrhoids under appropriate anesthesia. The fiber of the laser is inserted centrally into the hemorrhoidal node and energy is delivered. By this technique, hemorrhoids can be treated according to their size without causing any damage to the anoderm or mucosa.
  • If surgery is indicated, this therapy will provide you with an improved patient outcome especially regarding pain and recovery compared to conventional surgical proceeding for 2nd, 3rd, and 4th-degree hemorrhoids.
  • Under proper local or general anesthesia, the controlled laser energy delivery obliterates the hemorrhoids from the inside and preserves the mucosa and sphincter structures to an extremely high degree(Tissue reduction in the hemorrhoids).
  • The controlled emission of laser energy, which is applied submucosally, causes
    the hemorrhoidal mass to shrink.
  • In addition, fibrotic reconstruction generates new connective tissue, which ensures that the mucosa adheres to the underlying
    tissue.
  • This also prevents the occurrence or recurrence of prolapse. Laser hemorrhoidopexy is not associated with any risk of stenosis. Healing/result is excellent because, unlike conventional surgeries, there are no incisions/cut or stitches.
  • Access to the hemorrhoid is achieved by entering through a small perianal port. By this approach, no wounds are generated in the area of the anoderm or mucosa. As a result, the patient experiences less post-operative pain and can return to normal activities within a shorter space of time.
    1. No incisions
    2. No excisions
    3. No open woundsThree treatment principles with laser:
    1.  Reduction of the hemorrhoidal tissue, not total destruction/excision
    2. Reconstruction of the natural anatomy
    3. Nontouch of the anoderm

1. Diode Laser 980/1470nm
2. Laser Fiber: Delivery of energy in a conical shape

Characteristics of lasers fibers
1. Standard is bare fiber
2. Working mechanism: High temperatures on the fiber tip lead to a hot needle effect.
3. Temperature gradient to surrounding tissue structures.

  • Painless procedure
  • Outpatient or short hospital stay (overnight)
  • Short downtimes
  • No stenosis
  • No incontinence
  • No mucosa damaging
  • No foreign body insertion (no clamp complications)
  • Less complications
  • Safe procedure
  • Smaller wound
  • Low complication rate
  • Early Return to work
  • High patient satisfaction

Patients and Methods
Between November 2010 and November 2016, 497 patients (age 55 ± 14 years) were submitted to laser haemorrhoidoplasty with a 1470 nm diode laser in the center for minimally invasive proctology in Siegen District Hospital. All operated patients were included in the study. Perioperative clinical and technical data for up to 6 weeks and follow-up data for up to 6 months were analyzed prospectively.

Results
The mean duration of operation was 14 min (± 5.2). A mean of 2.7 knots of 2.7 size was treated per patient. The mean postoperative pain was 2.5/10 (VAS). Long-term symptom relevance was 86%, and patient satisfaction was 91%. Complications occurred in 49 patients (9.9%): bleeding 1.8%, infection 1%, urine retention 1.8%, oedema/thrombosis/prolapse 6.6%. 8.8% of patients suffered a relapse within 6 months. There were significant differences in pain on the day of the operation, and the parameters leucopenia, 3 treated segments, and energy level > 500 J (p < 0.05). Complications were more common when leucopenia was performed, with 3 treated knots and energy consumed per patient > 500 J. The only significant difference was for energy level > 500 J (p < 0.05).

Conclusion
LHP is a safe, low-pain, and minimally invasive surgical procedure with long-term good patient acceptance and satisfaction and is suited for routine work. The energy applied should be reduced to a minimum. Complication rates are largely comparable with those of other minimally invasive conventional methods. Additional prospective studies must be performed, particularly in comparison to the Parks method, which gives similar functional results. With circular confluent findings, LHP cannot replace stapler hemorrhoidopexia.

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