Saturday, September 6, 2014

ANAL FISSURE - Lifestyle and home remedies

Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences:
  • Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually.
  • Drink adequate fluids. Fluids help prevent constipation.
  • Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure.
  • Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear.
If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your infant's doctor.

Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing.
  • If your symptoms persist, you'll likely need further treatment.

    Nonsurgical treatments

    Your doctor may recommend:
    • Externally applied nitrogylcerin, to help increase blood flow to the fissure and promote healing, and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache.
    • Steroid creams, to help relieve discomfort.
    • Botulin toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
    • Blood pressure medications, which can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin in not effective or causes significant side effects.


    If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Surgery usually involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing. Surgery has a small risk of causing incontinence.

Piles (haemorrhoids) – basics, symptoms and treatment

What are haemorrhoids?

Haemorrhoids are swollen blood vessels in or around the anus and rectum. The haemorrhoidal veins are located in the lowest part of the rectum and the anus. Sometimes they swell so that the vein walls become stretched, thin, and irritated by passing bowel movements. Haemorrhoids are classified into two general categories: internal and external.

Internal haemorrhoids lie far enough inside the rectum that you can't see or feel them. They don't usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that they are there. Sometimes internal haemorrhoids  prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed haemorrhoids may hurt because they become irritated by rubbing from clothing and sitting. They usually recede into the rectum on their own; if they don't, they can be gently pushed back into place.
External haemorrhoids lie within the anus and are often uncomfortable. If an external haemorrhoid prolapses to the outside (usually in the course of passing a stool), you can see and feel it. Blood clots sometimes form within prolapsed external haemorrhoids, causing an extremely painful condition called a thrombosis. If an external haemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed haemorrhoids are usually not serious and will resolve themselves in about a week. If the pain is unbearable, the thrombosed haemorrhoid can be removed with surgery, which stops the pain.
Anal bleeding and pain of any sort is alarming and should be evaluated; it can indicate a life-threatening condition, such as  colorectal cancer. Haemorrhoids are the main cause of anal bleeding and are rarely dangerous, but a definite diagnosis from your doctor is essential.

What causes haemorrhoids?
Anyone at any age can be affected by haemorrhoids. They are very common, with about 50% of people experiencing them at some time in their life. However, they are usually more common in elderly people and during  pregnancy. Researchers are not certain what causes haemorrhoids. "Weak" veins - leading to haemorrhoids and other  varicose veins - may be inherited.
It's likely that extreme abdominal pressure causes the veins to swell and become susceptible to irritation. The pressure can be caused by obesity, pregnancy, standing or sitting for long periods, straining on the toilet, coughing, sneezing,vomiting, and holding your breath while straining to do physical labour.
Diet has a pivotal role in causing - and preventing - haemorrhoids. People who consistently eat a high-fibre diet are less likely to get haemorrhoids, but those who prefer a diet high in processed foods are at greater risk of haemorrhoids. A low-fibre diet or inadequate fluid intake can cause constipation, which can contribute to haemorrhoids in two ways: it promotes straining on the toilet and it also aggravates the haemorrhoids by producing hard stools that further irritate the swollen veins.

What are the symptoms of piles?

The symptoms of haemorrhoids include:
·         Bright red bleeding from the anus. Blood may streak the bowel movement or the toilet paper.
·         Tenderness or pain during bowel movements.
·         Painful swelling or a lump near the anus.
·         Anal itching.
·         A mucous anal discharge.

Seek medical advice if:

·         You have rectal bleeding for the first time, even if you believe you have haemorrhoids. Colon polyps,  colitis,  Crohn's disease, and colorectal cancer can also cause rectal bleeding. An accurate diagnosis is essential.
·         You have been diagnosed with haemorrhoids, and you have rectal bleeding that is chronic (daily or weekly) or more profuse than just streaking. Though rare, excessive haemorrhoidal bleeding can cause  anaemia.

How do I know if I have piles?

First, your doctor will look at the anal area, perhaps by inserting a lubricated gloved finger or an anoscope (a hollow, lighted tube for viewing the lower few inches of the rectum) or a proctoscope (which works like an anoscope, but provides a more thorough rectal examination).
More procedures may be needed to identify internal haemorrhoids or rule out other ailments that frequently cause anal bleeding, such as anal fissure, colitis, Crohn's disease, and colorectal cancer.
To see further into the anal canal (into the lower, or sigmoid, colon), sigmoidoscopy may be used, or the entire colon may be viewed with  colonoscopy. For both procedures, a lighted, flexible viewing tube is inserted into the rectum. A barium X-ray can show the entire colon's interior. First a barium enema is given and then X-rays are taken of the lower  gastrointestinal tract.

What are the treatments for piles?

There are treatments for piles available from pharmacies or through a GP.

Creams, ointments and suppositories can help relieve swelling and inflammation symptoms in the short term. A GP may recommend corticosteroid cream for severe inflammation.

Warm (but not hot) sitz baths are a traditional therapy for piles: sit in about 8 cm of warm water for 15 minutes, several times a day, especially after a bowel movement.

Painkillers, such as paracetamol, can help relieve pain caused by piles. Products with local anaesthetic may be prescribed to treat painful haemorrhoids.

If you are constipated, a GP may recommend using a laxative.

However, these treatments do not get rid of the haemorrhoids themselves.

If you are pregnant, discuss any treatment, including dietary changes, with your doctor before proceeding.

If symptoms persist, your doctor may suggest one of the following procedures. Many can be performed as a day-case:
Injection or sclerotherapy. An internal haemorrhoid can be injected with a solution that creates a scar and closes off the haemorrhoid. The injection will only hurt a little.

Banding. Prolapsed haemorrhoids are often removed using rubber-band ligation. A special tool secures a tiny rubber band around the haemorrhoid, shutting off its blood supply almost instantly. Within a week, the haemorrhoid shrivels and falls off.

Coagulation or cauterisation. Using either an electric probe, a laser beam, or an infrared light, a tiny burn painlessly seals the end of the haemorrhoid, causing it to close off and shrink. This is most useful for prolapsed haemorrhoids.

Surgery. For large internal haemorrhoids or extremely uncomfortable external haemorrhoids (such as thrombosed haemorrhoids that are too painful to live with), your doctor may choose traditional surgery, called haemorrhoidectomy.
The success rate for haemorrhoid removal approaches 95%, but unless dietary and lifestyle changes are made, haemorrhoids may recur.

Piles i e. Hemorrhoid and Fistula are diseases of blood vessel, either artery or vein. When distended blood vessels further distended or compressed may rupture and cause even torrential bleeding inside the anal canal. Piles is varicose vein of anus and rectum, it is also said to be aneurysm of blood vessel.
  • Gravity - Erect Posture. So occurs only in humans and not in animals.
  • Heredity - If one parent is having piles, the chance is higher in children and if both parents have piles, the chance for children is still higher.
  • Diet - Low fiber content in diet; fast food, tinned food, soft food, bakery food, lack of fruits and vegetables.
  • Smoking, alcohol, too much intake of chillies and spices and low intake of fluids.
  • Habit and Occupation - Constipation, diarrhea, sedentary life, lack of exercise, long sitting and standing, continuous cycle riding.
  • Frequent enema, excessive use of cold water
  • Mass per rectum bleeding per rectum Constipation
  • Feeling of incomplete emptying even after defecation
  • Feeling of frequent emptying
  • Frequency of irritation, pain motion, burning, itching.
  • Retention of urine.
  • Incontinence of urine and motion
  • Blood in motion:
(a) mixed with motion
b) marking
c) spraying
d) fresh flow
e) clots

  • Bengali Ligation - Crude and unscientific. Not observing sterile Technique. Even educated people are misled.
  • Rubber band ligation -Not effective. Temporary benefit for early piles only.
  • Injections of sclerosis agents - obsolete and not effective
  • Haemorrhoidectomy (Surgical removal of d) Needs longer hospitalization, Expensive, requires more man power and money. Does not guarantee 100% cure.
  • Cryosurgery - (Karikal) - Using ice and C02, Not effective, recurrence definite.
  • Stapling - Expensive and not very popular; Not without complication.
  • I.R.C - (German Technique) -infra Red Coagulation, less expensive, less pain, Effective for early piles, internal piles and for controlling bleeding.
  • KM 25 (DGHAL) (American Technique) -Vessel ligation Technique. Detecting the pulsation of the vessels using Doppler Guided Ultra sound and ligating the vessel. Very effective for internal hemorrhoid. Treatment time less than half an hour. Less pain, less bleeding and day care procedure. Can go home on the same day. Can do the routine from the next day.
  • C.T. Laser - Modern and effective method. Less pain, less bleeding, day care procedure, No recurrence, almost 100% effective for piles, fissure and fistula (both low & high)
  • HFLT - Modified form of laser: Less penetrating and hence less chance for charring and carbonization. Effective in presence of water and blood.


Cracks or cuts around the anus. Fissures appear in succession. Earlier ones heal and later ones appear causing scarring and stricture. Needs Anal dilation.
Symptoms - Pain, Constipation and bleeding.
Food - Patients better to avoid chillies and low fiber content diet.


Holes or opening in and around the anal canal. May remain healed at times and symptomatic at other times. Causing discharging, pus, fluid, blood, motion or both.
(i) Low fistula: Treatment: Using laser either cutting open or blind.
(ii) High fistula: Blind laser treatment May require 2nd sitting.


Due to laxity of pelvic muscles.
(a) Partial (mucosal) Treatment: mucosal ligation and laser excision.
(b) Complete: AH layers prolapsed
Tightening of anal sphincter and fixing the rectum of the pelvic muscles.
Causes of Rectal Prolapse:
2.Acquired Due to diarrhea, malnutrition

Al-Shifa Super Speciality Hospital for Piles based in Ernakulam, Kerala, is a hospital specialising in the treatmentt of Piles, Fistula and other related diseases. Incepted as a division of Al-Shifa Educational and Charitable Trust - a charitable institution running on a non-profit non-loss basis, the hospital has already earned the reputation of being the best-equipped hospital for piles treatment in India. The Hospital for Piles also provides high quality, compassionate and personalized health care coupled with efficient and empathetic nursing care...

Al-Shifa at a Glance


Tie Up Insurance:
  • Appolo Munich
  • E- Meditek
  • Family Health Plan
  • United Healthcare Parekh
  • ICICI Lombard
  • ICICI Prudential
  • IFFCo Tokio
  • MD India
  • Medsave
  • L & T Insurance
  • Paramount Health Care Services
  • Religare
  • M/s Cholamandalam Insurance Co Ltd
  • VIPUL Healthcare Services

Reimbursement Facility With:
  • TIK Health Care Services Pvt Ltd
  • Medi Assist India Pvt Ltd
  • Star Health And Allied Insurance Co. Ltd
  • LIC
  • United India Insurance Company
  • National Insurance Company Ltd
  • The New India Assurance Company Ltd
  • Royal Sundaram Health Insurance
  • Health India
  • Phenomenal Health Care Service
  • Medi Care TPA Pavt Ltd
  • Good Health Plan Ltd
  • Bajaj Allianz
  • Raksha TPA Pvt Ltd
  • Alankit Healhcare Pvt Ltd
  • Grant Healthcare Services Pvt Ltd
  • Happy Insurance Pvt. Ltd

Tie UP International Insurance Companies
  • NAS

Nutrition and diet
You can prevent constipation by following a high-fibre diet. Meals and snacks should consist primarily of vegetables, fruit, nuts, and whole grains, and as few processed foods and meats as possible. If this is a big change for you, introduce the new foods slowly, to avoid wind.
If you aren't able to eat enough high-fibre food, supplement your diet with stool softeners or bulk-forming agents. (Avoid laxatives, which may cause  diarrhoea that can further irritate the swollen veins.)
Drink at least eight glasses of water each day; if your life is especially active or you live in a hot climate, you will need more.
Monitor your salt intake. Excess salt in the diet causes fluid retention, which means swelling in all veins, including haemorrhoids.

At-home remedies
·         Try not to sit for hours at a time. If you have to, take breaks: once every hour, get up and move around for at least five minutes. A doughnut-shaped cushion can make sitting more comfortable and ease haemorrhoid pressure and pain.
·         Insert petroleum jelly just inside the anus to make bowel movements less painful.
·         Consider dabbing witch hazel (a soothing anti-inflammatory agent) on irritated haemorrhoids to reduce pain and itching.
·         Resist the temptation to scratch haemorrhoids, as it makes everything worse: the inflamed veins become more irritated; the skin around them becomes damaged; and the itching itself intensifies. Instead, to help reduce swelling and irritation consider using an over-the-counter steroid cream to the skin (not inside the anus - on the outside only) and a cold pack. You might try over-the-counter haemorrhoidal creams for relief from itching.
·         If you need a pain reliever, consider using paracetamol.
·         Bathe regularly to keep the anal area clean, but be gentle: excessive scrubbing, especially with soap, can intensify burning and irritation.
·         Don't sit on the toilet for more than five minutes at a time, and when wiping, be gentle. If toilet paper is irritating, try dampening it first, or use cotton balls or alcohol-free baby wipes. You may prefer washing yourself and then dabbing the area dry.
·         When performing any task that requires exertion, be sure to breathe evenly. It's common to hold your breath during exertion, and if you do, you're straining and contributing to haemorrhoid swelling.

 How can I prevent piles?
A healthy diet and lifestyle are good insurance for preventing haemorrhoids, whether you already suffer haemorrhoid symptoms or are intent on preventing them. Regular exercise is also important, especially if you have a sedentary job. Exercise helps in several ways: keeping weight in check, making constipation less likely, and enhancing muscle tone.

Healthy bowel habits also help prevent haemorrhoids. Use the toilet as soon as you feel the urge to do so. Also, avoid sitting on the toilet for prolonged periods (more than five minutes) and avoid straining during a bowel movement.

Monday, September 1, 2014

World’s First Laser Treatment centre for Piles & Fistula

AL-Shifa Super Speciality Hospital for Piles based in Ernakulam, Kerala, is a hospital specialising in the treatmentt of Piles, Fistula and other related diseases. Incepted as a division of Al-Shifa Educational and Charitable Trust - a charitable institution running on a non-profit non-loss basis, the hospital has already earned the reputation of being the best-equipped hospital for piles treatment in India. The Hospital for Piles also provides high quality, compassionate and personalized health care coupled with efficient and empathetic nursing care...
CTL Laser Technology:- Used exclusively for the treatment of Hemorrhoids introduced for the first time in India by Al-Shifa Super Speciality Hospital, Ernakulam
Laser Scanner:- Used Exclusively for cosmetic skin care 

KM 25 FDA recognized device :-  Used for the treatment of internal Hemorrhoids introduced for the first time in India by Al-Shifa Super Speciality Hospital Doppler Guided Ultra Sound 

Infrared Coagulator Technique :-  Achieves Haemostatic by arresting bleeding 

HFLT Technology (USA):-  Only Hospital using this technology for the treatment of Fistula. Array of European and American instruments. It is important to note that the whole treatment process will take about 20 to 30 minutes. As the treatment is non-surgical, the patients if he wants can go home on the same day.
     This Hospital is one of its kinds in India for the treatment of colorectal diseases affecting the rectum and anal canal.
     Centre of Excellence: Al-Shifa Super Speciality Hospital for Piles, a truly bold and pioneering initiative in the medical arena, has now grown into a ‘centre of excellence’ in the treatment of piles and related diseases using most modern laser technology.
     Al-Shifa Super Speciality Hospital has earned enviable reputation as one of the fastest growing hi-tech medical institution in the world for Piles at present.
     The hospital has carried out more  than 60,000 (fifty thousand) procedures using most modern and advanced technologies for the last 11 years and hence it is obvious that there is no such hospital in the world which has done such a huge number of procedures in the field of Piles and related diseases using most advanced laser technology.
     The Inpatient rooms are fully air conditioned and furnished in tune with the international norms and standards which includes VVIP, VIP suites, A/C deluxe rooms etc.
    The hospital offers an ideal system of therapy which is highly effective and result oriented as compared to other system of medicine used for the treatment of piles and other ano related diseases.
    The hospital offers most modern expertise for the treatment of Piles. We have full fledged monitoring system which helps us to provide the best treatment to our patients worldwide.
    We believe that a patient should be treated as a person rather than a set of symptoms. We strongly believe in certain principles which are honesty, dedication and truth.


In a severe case of hemorrhoid, surgery is usually recommended by the medical specialist. However, more people are turning towards Hemorrhoids laser surgery as a perfect solution for their woes. Laser treatment is usually used in acute cases of hemorrhoids or on patients who have had several recurrences of hemorrhoids. It is far more precise and accurate than most other techniques used to treat hemorrhoids.