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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for piles

Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 13176 Questions

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Posted on Mon, 16 Feb 2015 in Lump
Question: Hi,
I'm suffering from piles now. First it occurred 6 to 7 years back and from then it has been reappearing once or twice each year. With Ayurvedic medicine, it was cured within 4 to 7 days every time. Last year, it appeared in September and I went for one type of injection in the piles mass. The doctor said it would sollen first and then shrink and disappear after 15 to 20 days. But nothing happened like that.

since then, I've been continuously using Ayurvedic medicine but nothing working now. The pain and bleeding happened to be lessen but again it is there after eating any type of spicy food.

There is one large mass and two smaller mass around the anus. Pain is there; difficulty in sitting.

I'm thinking about going for LASER surgery as a friend told me that one of his relative was completely cured from piles with this 4 years ago without reoccurence.

Please advice me in this regard. I'm 35 years old and also, I'm diagnosed with diabetes last year.

Thanks in advance for any help.
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
Get a confirmed diagnosis first ...

Detailed Answer:
Hi.
Thanks for your query and an elucidate history, nicely put so that the diagnosis is obvious.

Piles do not cause pain unless they are prolapsed and thrombosed.
This means you are suffering from the piles as well as fissure in ano, in which there is a small would at the anal opening.

First of all I would like you to see the General Surgeon or Surgical Gastroenterologist. This is for local examination, ano-proctoscopy and colonoscopy as your age is 35 years. This will give the perfect diagnosis. A proper diagnosis is a must before a proper treatment is instituted.

Secondly, you have to have a well control over the diabetes if you want the best results.

Thirdly, Once the diagnosis is made, a proper treatment can be planned.

You may need an anal dilatation and excision and ligation of the piles. Excision and Ligation means the piles are dissected up to the root and ligated at the base so that the recurrence is not there . This can be achieved by open operation in the regular way.

Please inquire your friend in which center the Laser surgery was done. Whether Laser was used to dissect or to obliterated the mass.

Please let me know which city do you reside.
The role of the Ayurveda and Homeopathy is there but since this is not helping you, you may please stop these therapies altogether and follow the advise of a Surgeon, which may be as follows :::
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation.
Laxative for softening the stool- never allow the dose too much to cause liquid stools.
Sitz bath- very important- just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5 day course of an antibiotic on prescription of a local Doctor.
Add probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.

I hope this answer will helps you to get the most proper diagnosis and curative treatment. Please feel free to ask for more if you need to or if you feel there is a gap-of-communication.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 42 hours later
Hello Dr,
Thank you very much for the detailed analysis and suggestion. I would like to ask some more questions for further understanding.
First of all, I’m in XXXXXXX XXXXX. My sugar level is around 100 (FBS) & 130(PPBS) with regular medication. My HbA1C report is 6.4. I think this is quite normal for any surgical requirement.

My normal daily diet is; 1 or 2 apples in the breakfast, 3 roti and cooked papaya and other cooked vegetables in lunch and either 2 roti with sabji or salad and one glass milk in dinner. Some time I use spicy or nonveg like fish but very moderately.

Should I avoid the spicy food and fried ones completely for the rest of my life or can I take them moderately?

Which is more harmful; spicy or fried food like vada, samosa etc?

Is fried vegetable (bhaji as we Indians called) okay?

Should I avoid non veg food like egg, mutton, chicken, fish completely or moderately? Most doctors differ in this case. Some say chicken and egg should be avoided; some say mutton is the real enemy, totally confused. So I’m now completely avoiding these except fish. Is all these should be avoided for the rest of my life?

What about cold drink, tea and coffee? Now I’m in the habit of 2 cup of tea or coffee daily.

Previously, I’m in the habit of morning walk of about 4 to 5 km. But due to the recent development and pain, I fear to go for it. Should I continue it or I can wait till I recover?
Should I have to go to bed early?

Which type of surgery is the best for my situation as per your opinion? Some resource in the net say LASER is the best with less pain and recovery time whereas authoritative sources like Webmd or nhs.uk are saying there is nothing specific advantages of it over other methods.

If I go for LASER, what would be the recovery time and pain; can I resume work in one week.? What about post-operative complication? What is the chance of reoccurrence in future.

My friend couldn’t tell about the procedure you wanted me to ask. Within next three days I’ll visit a doctor and will definitely ask that.

As I’m slowly recovering with Ayurvedic medicine (Pilocheck from Dabur & Nagarjuna Yog), can I use antibiotic with these for faster recovery? Also I’m using the cream Pilex from Himalaya. Should I replace it with the one you mentioned in the earlier mail? Actually I am too worried hearing lot of horror stories about after operation conditions of patients all over the web. So I think I’ll give it a last try for 10 days and then I’ll go for operation. Please guide me in this regard.

This is long list of questions and I know you are very busy from your profile. But please help me as much as possible. Also, as I’m in XXXXXXX which is the best place here for operation?

Really waiting for your kind reply. Thanks again.

Regards.
XXXXXX
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Find the Surgeon with good name in Piles ...

Detailed Answer:
Hi XXXXXXX Good noon.
Nice to know you are in XXXXXXX As this is a Capital city, there must be many great General Surgeons, particularly those who have great name in Practo-anal Surgery.

Reports of Sugar and HbA1c are perfectly OK for any surgical procedure.

Diet:
It is good plan you are implementing. Continue whatever you are taking on daily basis.
Spicy food or oily food to be stopped only if you have noticed any adverse effect for you in person or for the disease you have. If no side effects you can certainly continue in moderate amount to satisfy the tongue... Same is try for any of the non-veg food. IF it is not causing or enhancing any of your problems, you can continue.
The simple-thumb rule is : Consume anything which does not cause any problem whatsoever. If there is anything that causes, enhances any of the problem for the body / stomach or your present problems.
Same about tea or coffee.
As for Samosa or any junk foods: you can take these only if it is made in your home, otherwise try to avoid any of the junk foods and beverages with preservatives like cola and so. Strictly - no , no for such things.

If there is no pain or discomfort in walking , please continue.
Early to bed is definitely a good sign of good lifestyle.

Please stop searching on internet as these information may confuse you since there is no interaction with you and the Doctor so unless one knows the exact diagnosis of your problem and the stage in which you are in and presence of other so many factors that have direct bearing on your well-being.

Get Examined by a General Surgeon who has a great name in Piles / Fissures.
You can try the one your friend knows about. Talk to many people around you, you will automatically come to know the best Surgeon in Town.

As I have already said, lasers have no upper-hand. Any surgery done by a nice skilled Surgeon with utmost care will be beneficial if you follow the instructions carefully.
The chances of complications / sequel are less now-a-days as everything has improved, the understanding, techniques, instrumentation, and so on. So your job at the moment is to fins the Surgeon with best name, get examined, discuss and follow-on.

Your Surgeon will be the best to tell you about the sequel, possible complications , time of recovery etc as per his techniques and experience, and after the decision as what exactly has to be done.
Te chances or recurrence are very minimal now-a-days as the treatment is always directed towards permanent cure.

Yes you can take antibiotics with the present medications you are already taking . Continue Pilex ointment.

Do not worry, this is a curable problem. Stop thinking about you and your recovery starts now !
I will try to find one Good Surgeon in your City.
Please talk to other people around you and ask for more information about the best Surgeon in your City.
XXXXXXX stop worrying, start believing in, accepting the facts.
All the best ..
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 24 minutes later
Hello Sir,

Thank you so much! You don't know how much helpful your detailed answer is! And the best thing about it is the part regarding the food. most others tell what they believe but yours is very practical.

I'll try to find out the best surgeon here and will go for surgery. I'll let you know about it and surgery and post operative conditions so that you can help other persons in our locality like me if you happen to find them here. But please let me know if you find one. As a doctor refereed by another one is the best reference.

Your words are really a source of courage and inspiration to me to lead a healthy lifestyle. It seems like GOD has sent you to answer my confusions build-up for many months.Thank you so much again.

If you don't mind I'll catch you in other platform like Google Plus later on.

Regards,
XXXXXX
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Thanks for your appreciation.

Detailed Answer:
Hi XXXXXXX
Thanks for your appreciation.
Yes we will be in touch, please keep me posted the further progress. With the positive attitude, you will be having far better results, healing and benefits. Please get knowledge about the best Surgeon dealing in such cases by talking to people / treated / operated patients around.

I can give a hint. Medical Colleges has XXXXXXX Surgeon, try to get a knowledge about them too. At least one is famous for piles and fissure.

I am not active on Google plus, active only on facebook as Drt Chandrakant.
We can be touch on this platform of Ibix- HealthcareMagic..

All the best, relax and have great recovery.
You may rate these answers before closing the thread.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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