Laser Surgery For Piles

Haemorrhoids or piles are swollen veins in your anus and lower rectum. It can develop inside the rectum (internal haemorrhoids) or under the skin around the anus (external haemorrhoids).

How to tell that you have piles?

According to Dr. Purnendu Bhowmik, considered to be the best piles doctor in Kolkata, you are likely to have piles, if you experience

Itching or irritation in your anal region

Pain or discomfort

Swelling around your anus

Bleeding per rectum

When to see a doctor?

If you have bleeding during passage of stool or you have piles that does not improve even after a week of home care, talk to the best piles specialist doctor in Kolkata.
(Do not assume every per rectal bleeding to be due to hemorrhoids, especially if it is associated with change in bowel habit and or change of stool color and/or consistency. Bleeding in your rectum may occur with other conditions, including colorectal cancer and anal cancer.)

How to prevent piles?

The best way you can prevent piles is by avoiding constipation and by keeping your stool soft. You can follow these tips:

Eat high-fiber foods

Drink plenty of fluids

Consider fiber supplements

Go as soon as you feel the urge

Don’t strain

Exercise

Avoid long periods of sitting

Do haemorrhoids ever resolve spontaneously?

Small haemorrhoids may disappear without any treatment within a few days. But, larger piles need intervention to cure. If you have symptoms and have not improved with home care within a few days, it is best to see a doctor for piles treatment in Kolkata.

What happens if you leave a hemorrhoid untreated?

If left untreated, hemorrhoids can increase in size, upgrade and protrude out of the anus to cause irritation, severe bleeding and other severe complications. Moreover, if you avoid being examined by a doctor, you may miss other disease which might sometimes present as piles.

 Is piles curable or not?

Fortunately, they are treatable and curable if managed properly.

 Is laser piles treatment in Kolkata safe?

Yes. Laser procedure for piles is absolutely safe in the hand of a qualified & well trained laser surgeon.

 Can laser piles surgery remove/cure haemorrhoids?

Hemorrhoid laser procedure (LHP) is a new technique in which haemorrhoidal arterial flow feeding the haemorrhoidal venous plexus is stopped by laser coagulation. Laser piles surgery, when applicable, is preferable over other form of treatment as it not only is a bloodless & painless procedure but also provides quick recovery.

 How painful is laser haemorrhoid surgery?

Laser Babasir treatment, a term used for haemorrhoid surgery, is painless or in some cases, minimally painful.

What are the advantages of laser piles surgery over conventional surgical procedures?

piles

Why do you choose laser over other procedures for piles?

  • USFDA approved
  • Day-care procedure
  • Faster recovery
  • No stitches, no wound, no dressing, no scar
  • Bloodless, painless
  • No need of prolonged medication
  • No anal stenosis, no constipation
  • Minimal recurrence, high success rate

What our patients say

Haemorrhoids are clusters of smooth muscles, vascular and connective tissues, which lie along your anal canal in 3 columns—left lateral, right anterior, and right posterior positions. Hemorrhoids are present universally in healthy individuals. Hemorrhoids aid in the process of bowel movement. Nonetheless, the term “haemorrhoid” is commonly invoked to characterize the pathologic process of symptomatic hemorrhoid disease instead of the normal anatomic structure. As the supporting tissue of your anal cushion weakens, downward displacement of the cushions can occur, causing venous dilation and prolapse.

What Causes Haemorrhoids?

Haemorrhoids do not occur due to a single causative factor, says the best laser surgeon in Kolkata. Most often, however, they are caused by an increased pressure on the anal canal. This can be due to:

  • Chronic (ongoing) constipation
  • Straining during bowel movements
  • Diarrhea
  • Pregnancy and childbirth
  • Sitting too long on the toilet
  • Strenuous exerciseor heavy lifting
  • Aging

Classification of a hemorrhoid

  • External haemorrhoids, located below the dentate line, are covered with anoderm and consist of squamous epithelium. They are innervated by somatic nerves supplying the perianal skin and thus cause pain.
  • Internal hemorrhoids, located just above the dentate line, are covered by columnar epithelium, innervated by visceral nerve fibers and thus cannot cause pain.
  • Grade I haemorrhoids don’t project from your anus. They may cause bleeding, but otherwise cause relatively less symptoms.
  • Grade II hemorrhoids are the ones that stick out from the anus during bowel movements. They go back to their initial position when straining stops.
  • Grade III hemorrhoids stick out with straining or on their own. They do not get resolved by themselves, however, they can be pushed back into their initial position.
  • Grade IV hemorrhoids are the ones that stick out, but cannot be reduced. These are extremely painful and require prompt treatment.

Symptoms and Presentation

Almost 40% of individuals with hemorrhoids are asymptomatic. For those who are symptomatic, there is great variance in the constellation of symptoms. For internal hemorrhoids, the following signs and symptoms are experienced:

  • Bleeding: It is one of the most common symptoms that occur with defecation and is almost always painless.
  • Pulling sensation in the pelvis: Prolapsed internal hemorrhoids are accompanied with mucus discharge, mild fecal incontinence, irritation of perianal skin, and sensation of perianal fullness.
  • Pain associated with internal hemorrhoids is lesser than that with external hemorrhoids, but it can occur in the setting of prolapsed internal hemorrhoids that develop gangrenous changes due to the associated ischemia. In contrast, in external hemorrhoids, pain is most common due to activation of perianal nerves associated with thrombosis. People usually describe a painful perianal mass that is tender to palpation.
  • Bleeding also occurs if ulceration forms due to necrosis of the thrombosed hemorrhoid
  • Painless external growths on skin usually develop from previous edematous or thrombosed external hemorrhoids.

 Evaluation

  • Digital examination – It excludes distal rectal mass and anorectal fistula or abscess. Assessment of sphincter integrity during the examination process is important.
  • Anoscopy-It involves rigid or flexible proctosigmoidoscopy.
  • Colonoscopy – It is used for complete colonic evaluation.

Management

Conservative Medical Treatments

Dietary and lifestyle modifications are one of the most important aspects of conservative treatment. Specifically, lifestyle modifications include greater intake of oral fluids, reduction in fat consumption, regularly exercising, and avoiding straining. Dietary recommendations include increase in fibre intake that lessens the shearing action of passing hard stool.

Nonsurgical Office-based Procedures
 Rubber Band Ligation

It is typically performed in the office and is used for grade II and III internal hemorrhoids.

 Sclerotherapy

It is used for patients with grade I and II internal hemorrhoids and may be a good option for patients on anticoagulants.

 Infrared Coagulation

It refers to the application of infrared light waves to the haemorrhoidal tissues and can be used for grade I and II internal hemorrhoids.

Cryotherapy

It is based on the concept that freezing the internal hemorrhoid at low temperatures results in tissue destruction.

Operative managements

For symptomatic Grade ΙΙΙ-ΙV hemorrhoids and hemorrhoids resistant to non-operative procedures, a surgical procedure can be adopted. It is required in only 5-10% of patients.

Haemorrhoidectomy

The best proctologist in Kolkata usually performs two major types of haemorrhoidectomy: Ferguson, or closed haemorrhoidectomy and Milligan–Morgan, or open haemorrhoidectomy

 Stapled Haemorrhoidopexy

An alternative to operative haemorrhoidectomy, it is a stapled procedure in which a circular stapling device is used to resect and fixate the internal hemorrhoid tissues to the rectal wall. The technique is also known as ‘procedure for prolapse and hemorrhoids (PPH)’. This is comparatively less painful and allows quicker recovery.

Doppler-guided Hemorrhoidal Artery Ligation

It involves a Doppler transducer allowing sequential identification of the position and depth of superior rectal arterial branches, which are then selectively ligated 2-3 cm above the dentate line. The interference with the blood supply reduces bleeding and volume of the hemorrhoids and symptomatic relief is usually evident within 6-8 weeks.

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