Monday, September 1, 2014


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

1 comment:

  1. nice blog
    thanks for sharing information.
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