Piles Treatment - Types, Diagnosis, Surgery & Recovery

Diagnosis of Piles

A proctologist may recommend some tests to diagnose the severity of the condition. Here’s an overview of the diagnostic tests followed before the surgery:

Medical history: During the consultation, your doctor may ask you about your symptoms that may include pain, itching, bleeding etc. They may also ask you if you have a history of piles.

Digital Rectal Exam (DRE): In some cases, doctors may suggest DRE in which they insert a lubricated glove into the rectum to check for lumps and any other abnormalities.

Anoscopy or Proctoscopy: These procedures involve the use of a small, lighted tube (anoscope or proctoscope) to examine the anal canal and rectum closely. They help assess the location, size, and severity of piles and guide the treatment plan.

Sigmoidoscopy: This procedure uses a sigmoidoscope (a lighted tube with a camera) to view the lower colon and rectum. It helps identify conditions like piles and is available in flexible and rigid types.

Colonoscopy: Colonoscopy examines the large intestine for abnormalities, including rectal bleeding from piles or other causes. It helps rule out serious issues, guiding the doctor in recommending the right piles treatment.

Treatment Options for Piles

Piles can be treated using different methods- surgical and non-surgical. Let us first discuss some common non-surgical methods to treat piles, such as:

Rubber Band Ligation

Rubber band ligation is a commonly used non-surgical treatment for internal piles. During this procedure, the doctor inserts a viewing scope called an anoscope into the anus to see the internal piles.

A special instrument known as a ligator is used to place a small rubber band at the base of the piles. The purpose of the rubber band is to cut off the blood supply to the piles, causing them to shrink and eventually fall off within a few days. Rubber band ligation is a relatively simple and effective procedure that takes about 30 minutes to complete.

After the procedure, patients can usually go home, and the recovery time is typically short, with most individuals able to resume their normal activities within a few days.

Sclerotherapy

Sclerotherapy is another non-surgical option used to manage piles. This procedure involves injecting a special solution called a sclerosant directly into the affected vein. The sclerosant irritates the lining of the vein, causing it to shrink and eventually fade away.

Sclerotherapy is typically used for the treatment of internal piles. Since it is a non-surgical approach, it generally offers a faster recovery time compared to surgical interventions.

Infrared Photocoagulation

Infrared photocoagulation is a medical procedure used to treat small and medium-sized internal piles. During this treatment, the doctor uses a device that produces an intense beam of infrared light. The heat generated by infrared light causes scar tissue to form on the walls of the anal canal and around the piles.

The scar tissue serves to cut off the blood supply to the piles, causing them to shrink and eventually fall off. Additionally, the scar tissue helps to hold nearby veins in place, preventing them from bulging into the anal canal. Infrared photocoagulation is usually a quick procedure, and most individuals can resume their normal activities immediately after the treatment.

Electrocoagulation

Electrocoagulation is a procedure that uses an electric current to destroy the piles. In this procedure, a proctoscope is inserted into the anus to locate the piles.

A probe is then placed at the base of the piles, and an electric current is delivered to the piles using a handpiece connected to the probe. The purpose of the electric current is to thicken the blood in the vessels and cauterize them at the base, causing the piles to shrink.

The recovery time after electrocoagulation can vary from person to person and depends on factors such as the size and severity of the piles, as well as individual healing capabilities.

In serious or complex cases of piles, the doctor may suggest surgery. Some common surgeries suggested for piles treatment include:

Open Surgery (Open Hemorrhoidectomy)

Open surgery involves making an incision in the anal region to locate the piles. The incision is generally made around the anus or in the anal canal, depending on the location and severity of the piles.

The surgeon carefully removes the piles using surgical instruments, and the technique may involve excising the piles or ligating them with sutures to restrict their blood supply. The goal is to completely remove or reduce the size of the piles. The complete recovery time after open surgery for piles can vary from several weeks to a few months, depending on the extent of the surgery, individual healing abilities, and adherence to post-operative care instructions.

Stapler Surgery (Stapled Hemorrhoidectomy)

Stapler surgery, also known as stapled hemorrhoidectomy, is a surgical method for treating piles. This approach utilizes a stapling device to remove the piles tissue. Stapler surgery is recommended for patients whose piles have prolapsed or become abnormally large, or who have shown little or no improvement with nonsurgical treatment. During stapler surgery, the piles tissue is lifted into a ring of tissues using sutures, and a stapler removes the excess tissue, restricting blood flow to the piles.

As a result, patients who undergo stapler surgery typically experience less pain than those who undergo traditional piles surgery. They also experience less bleeding, itching, and swelling around the anus and inside the rectum. Recovery from stapler surgery is usually quicker and linked to fewer complications.

Laser Surgery

Laser surgery or laser hemorrhoidectomy is considered the safest and most effective surgical option for treating piles. In this procedure, laser energy is used to shrink and coagulate the piles tissue. The laser energy precisely targets the piles, causing them to shrink without affecting the surrounding healthy tissues.

Laser surgery is a minimally invasive approach and is typically performed on an outpatient basis, meaning patients do not need to stay overnight at the hospital. Laser surgery is associated with minimal postoperative pain and a relatively shorter recovery time compared to other surgical methods.

Benefits of Laser Piles Surgery

Laser piles surgery offers various benefits over traditional procedures to treat piles. Some common benefits of laser hemorrhoidectomy are mentioned below.

1. Minimally Invasive: Laser piles surgery is a minimally invasive procedure that offers several benefits over traditional surgical methods. The laser energy is used to precisely target and treat the affected areas, minimizing damage to surrounding healthy tissue. This results in reduced pain, less bleeding, and faster recovery times for patients.
2. Precision and Accuracy: The use of laser technology in piles surgery allows for precise and accurate treatment. The laser beam can be adjusted to the desired depth, ensuring that only the affected tissue is targeted while leaving the healthy tissue untouched. This precision minimizes the risk of complications and improves the overall effectiveness of the procedure.
3. Reduced Pain and Discomfort: Laser piles surgery is associated with less postoperative pain and discomfort compared to traditional surgical methods. The laser energy seals blood vessels as it cuts, reducing bleeding and nerve stimulation. This results in a more comfortable recovery period for patients.
4. Minimal Scarring: Laser piles surgery leaves minimal scarring compared to traditional open surgery. The laser beam cauterizes blood vessels and tissues as it cuts, promoting faster healing and reducing the risk of visible scars. This can be particularly beneficial for patients who are concerned about the cosmetic appearance of surgical scars.
5. Faster Recovery: Laser piles surgery typically allows for a faster recovery compared to traditional surgical methods. The minimally invasive nature of the procedure means that there is less trauma to the body, resulting in less pain, swelling, and bruising. Patients can often return to their normal activities sooner, leading to a quicker return to their daily routine.
6. Reduced Risk of Complications: Laser piles surgery is associated with a lower risk of complications compared to traditional surgical methods. The precise targeting of the laser energy reduces the risk of damage to surrounding structures, such as muscles and nerves. This can help minimize the risk of complications such as infection, incontinence, and anal strictures.
7. Outpatient Procedure: Laser piles surgery is often performed on an outpatient basis, meaning that patients can go home the same day as the procedure. This eliminates the need for an overnight hospital stay and allows patients to recover in the comfort of their own home. This can be particularly beneficial for individuals who prefer to minimize their time spent in the hospital.

Candidates for Laser Piles Surgery

• Chronic Hemorrhoids: Laser piles surgery is recommended for individuals suffering from chronic hemorrhoids, which refers to the recurrent enlargement and swelling of the blood vessels in the rectum and anus. These individuals may experience persistent pain, itching, bleeding, and discomfort.
• Failed Conservative Treatments: Candidates for laser piles surgery also include those who have tried and failed to find relief through conservative treatments such as dietary changes, topical creams, and over-the-counter medications. When these non-invasive measures prove ineffective, laser piles surgery becomes a viable option.
• Severe Symptoms: Individuals with severe symptoms of hemorrhoids, including significant bleeding, prolapse (when the hemorrhoids protrude from the anus), and incontinence, may be suitable candidates for laser piles surgery. This procedure can provide long-lasting relief from these distressing symptoms.
• Internal Hemorrhoids: Laser piles surgery is particularly beneficial for individuals with internal hemorrhoids, which develop inside the rectum. These internal hemorrhoids can be effectively treated using laser technology, which allows for precise targeting and minimal damage to surrounding tissues.
• Good Overall Health: Candidates for laser piles surgery should be in good overall health to ensure a successful outcome. It is crucial to undergo a thorough medical evaluation to assess the suitability for surgery and identify any potential risks or complications.

Preparation Tips for Piles Laser Surgery

Here’s how you can prepare for your piles surgery:

• Consult with an experienced proctologist to assess your eligibility for piles laser surgery.
• Follow any specific instructions given by your doctor regarding diet and medication.
• Inform your doctor about any allergies or medical conditions you have.
• Avoid consuming any blood-thinning medications or supplements for a specified period before the surgery.
• Follow a balanced diet rich in fiber to promote regular bowel movements and reduce the risk of constipation.
• Stay hydrated by drinking an adequate amount of water throughout the day.
• Take a stool softener or fiber supplement to ease bowel movements during the recovery period.
• Arrange for a responsible adult to accompany you to and from the surgery, as you may require assistance.
• Ensure that you wear loose and comfortable clothing on the day of the surgery.
• Prepare your home environment by placing essential items within easy reach, such as medications and sanitary supplies.
• Clear your schedule for the recommended recovery period to allow for sufficient rest and healing.
• Familiarize yourself with the post-surgery care instructions provided by your doctor.
• Avoid smoking or consuming alcohol in the days leading up to the surgery, as they can interfere with the healing process.
• Arrange for someone to take care of any dependents or pets during your recovery period.
• Follow any additional instructions provided by your doctor to ensure a smooth surgery experience.

Remember to consult with your doctor for personalized advice and guidance based on your specific medical needs.

Recovery Tips After Laser Piles Surgery

Here are some recovery tips to follow after laser piles surgery:

• Take prescribed pain medication as directed by your doctor.
• Apply ice packs to the surgical area to reduce swelling.
• Avoid sitting or standing for long periods of time to minimize discomfort.
• Eat a high-fiber diet to prevent constipation and promote healing.
• Stay hydrated by drinking plenty of water throughout the day.
• Take short walks to improve circulation and prevent blood clots.
• Use stool softeners or laxatives if necessary to prevent straining during bowel movements.
• Avoid lifting heavy objects or engaging in strenuous activities until cleared by your doctor.
• Keep the surgical area clean and dry to prevent infection.
• Follow all post-operative care instructions provided by your surgeon.

Remember, it is important to consult with your doctor for personalized recovery advice after laser piles surgery.

Risks and Complications Associated with Laser Piles Surgery

Like any other surgery, laser hemorrhoidectomy also comes with some risks and complications associated with it. Some of them are mentioned below:

• Infection: There is a risk of infection at the site of the laser piles surgery, which may require antibiotics or further medical intervention.
• Bleeding: Bleeding during or after the procedure is a potential complication requiring immediate medical attention to prevent excessive blood loss.
• Pain and Discomfort: Patients may experience pain and discomfort following laser piles surgery, which can be managed with pain medications prescribed by the doctor.
• Scarring: Laser piles surgery may result in scarring, although it is typically less prominent than with traditional surgical methods.
• Recurrence: There is a possibility of piles recurrence after laser surgery, although the likelihood is generally lower compared to other procedures.
• Urinary Problems: Some patients may experience difficulties with urination, such as urinary retention or urinary tract infections, following laser piles surgery.
• Incomplete Piles Removal: In some cases, laser piles surgery may not completely remove all the piles, requiring additional treatment or alternative procedures.
• Anal Stenosis: Narrowing of the anal canal, known as anal stenosis, can occur as a complication of laser piles surgery, leading to difficulties with bowel movements.
• Fecal Incontinence: Rarely, laser piles surgery can result in fecal incontinence, where the patient has little or no control over bowel movements.
• Anesthesia Risks: As with any surgical procedure, there are inherent risks associated with anesthesia administration, including allergic reactions and adverse effects on the cardiovascular and respiratory systems.