Piles & fissure
Fistula
- Piles Diagnosis
In the case of external piles, the doctor can diagnose them with a physical inspection. However, in case of internal haemorrhoids, the proctologist will perform a digital examination to insert a gloved, lubricated finger into the rectum to check for abnormal growth. Additionally, to correctly diagnose internal piles, the surgeon may choose a proctoscope, an anoscope, or a sigmoidoscope to examine the lower rectum. - Laser Surgical Treatment
Laser-assisted surgery for piles is one of the most efficient treatment methods. During the procedure, a focused narrow beam of light is used on hemorrhoid to ablate or shrink it without affecting the surrounding tissues. It is an advanced, minimally invasive procedure that aids the patient’s faster recovery.
The recovery from piles laser operation may differ for individuals. However, it takes about 30-45 days to recover completely.
You must also keep in mind the following:
- First, ensure that you keep the surgery site clean to avoid infection.
- Take sitz bath regularly.
- Avoid lifting heavy weights as that adds additional strain to the surgical site.
- Eat meals that are nutritious and high in fiber content. Avoid oily and spicy foods.
- To ensure you are hydrated, drink at least 8-10 glasses of water every day.
- Do not strain yourself during your bowel movement.
- If your bowel movements are hard, consider taking stool softeners to alleviate the strain (only after consulting the doctor).
- Be diligent about taking medications and applying ointments/creams prescribed by your doctor.
- Minimal Bleeding & Pain: There is minimal blood loss during laser surgery and reduced pain post-surgery since the laser only targets a specific area.
- Improved Precision: Laser surgery imparts precision by targeting smaller areas without damaging the surrounding tissues.
- Day Care Surgery: Piles laser surgery is a day care surgery, i.e., you will be discharged the same day unless the doctor deems otherwise.
- Shorter Recovery Time: Since it is a minimally invasive procedure, the recovery time is much lesser.
Anal fissures can be caused by various reasons like chronic diarrhea, chronic constipation, injuries, and underlying conditions like Crohn’s disease, anal cancer, STDs, etc.
There are 2 main types of Anal Fissure:
- Acute: In this type of anal fissure, the tear looks like a paper cut and is more surface-level and can be treated with topical ointments, medications, a high fiber diet, and home treatments like sitz bath.
- Chronic: In chronic anal fissure, the fissure has a deeper tear accompanied by internal and external growths. If a fissure lasts more than 2 months, it is considered chronic. These types of fissures are better treated with surgery.
Anal Fissure Diagnosis
Aapka Care proctologists are highly experienced and may diagnose an anal fissure with a physical examination. However, the doctor may prescribe additional tests to diagnose the condition correctly and rule out complications. The standard diagnostic tests for anal fissures include Sigmoidoscopy, Anoscopy, and Colonoscopy.
Anal Fissure Treatment
If your anal fissure doesn’t heal with medication and other treatments, it could indicate a chronic condition. Laser-assisted surgery is one of the most effective treatments for chronic anal fissures. During this procedure, the patient is first administered general or local anesthesia. Then, once he is asleep, the surgeon uses the laser probe that emits laser radiation to heal the tears in the mucosa. This treatment is a daycare procedure, and the patient can go home the same day unless the doctor advises otherwise.
While preparing for the surgery, it is essential to follow all instructions given by your doctor to ensure that your recovery process is on track.
- Let your doctor know in advance if you’re allergic to any medications.
- Avoid heavy meals the night before the surgery.
- Avoid drinking and smoking a week before the surgery.
- Eat a light meal on the day of the surgery. Avoid heavy foods that are high in fats and carbs.
You may need to take a few precautions before your laser surgery as it helps your surgery go over smoothly and aids in post-surgery recovery.
- Inform your doctor in advance if you have any allergies (to specific medications and otherwise) and if you take medications for pre-existing conditions.
- Avoid smoking and drinking alcohol in the days leading up to the surgery.
- Eat a light meal on the day of the surgery. Avoid heavy foods that are high in fats and carbs.
There are 4 different types of anal fistulas.
- Inter-sphincteric: the fistula tract is between the internal and external sphincter muscles, and the opening of the fistula is very close to the anal opening.
- Trans-sphincteric: the fistula tract goes through the internal and external anal sphincters and opens an inch away from the anal opening.
- Supra-sphincteric: the fistula tract begins in the space between the sphincters, turns upwards toward the puborectal muscle, crosses it, and then extends downwards and opens 1-2 inches outside the anus.
- Extra-sphincteric: this fistula tract begins at the rectum and extends downwards to the perianal skin. Diverticulitis or Crohn’s disease commonly causes these types of fistulas.
For all types of anal fistulas, surgical intervention is the best treatment option to lower the risk of recurrence
If you’re dealing with an anal fistula, it is advised that you must visit a proctologist and seek treatment as soon as possible. While home remedies may help manage symptoms, surgery is the only way to heal an anal fistula. In addition, an untreated fistula can give rise to complications for a patient.
- May turn cancerous: Research has shown that an untreated anal fistula is more likely to develop cancer in the tract.
- Extension of fistula: An unhealed fistula tract will extend and cause increased damage to more anal and rectal areas.
- Fistula drainage: Untreated fistulas present with foul-smelling pus discharge.
- Incontinence: A chronic or untreated fistula may lead to fecal incontinence due to damaged sphincter muscles.
- Sepsis: Untreated fistulas may cause sepsis, a body’s extreme response to prolonged infection.
You can treat anal fissures to some extent with the help of the following:
- Taking regular sitz bath to help relax the anal muscle and help irritation
- Over-the-counter stool softeners
- Drinking adequate amounts of water and improving digestion
- Eating more fiber in your diet and taking fiber supplements.