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Piles Surgery in Mumbai

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Hemorrhoid (Piles) Surgery in Mumbai & Cost Procedure - AHC

Hemorrhoids are swollen, enlarged, and inflamed veins inside and outside the Anus & Rectum. Piles is another term for hemorrhoids. 

Hemorrhoids may cause pain, severe itching, and difficulty sitting.   Fortunately, they’re treatable.

ETIOLOGY:-

The scientific study for hemorrhoids is mainly based on:- 

  • Familial / heredity 
  • Constipation
  • Straining
  • Pregnancy 
  • Obesity 
  • Prolonged sitting
  • Chronic Diarrhea
  • Portal Hypertension
  • Low-fiber food 
  • Increased intra-abdominal pressure 
  • Increased sphincter abnormalities

Causes:-

you may likely get hemorrhoids if you have a family history of hemorrhoids.

Building pressure on your lower rectum which can affect blood flow and make their veins swollen.

THE CAUSES OF HEMORRHOIDS:-

  • Straining during bowel syndrome 
  • Sitting on the toilet for a long period of time 
  • Chronic Constipation or Diarrhea
  • A low fiber Diet
  • Weakening of the supporting Tissues in your anus & rectum 
  • Pregnancy
  • Often lifting heavy objects. 
  • People who sit or stand for long stretches are at greater risk of suffering hemorrhoids.

Types of hemorrhoids (Internal vs. external)

  • Internal hemorrhoids:- occur within the rectum and are usually not visible during an external examination. However, in some cases, an external pile may grow to protrude outside of the anus. The medical term for this is prolapsed hemorrhoid.

CLASSIFICATION OF INTERNAL HEMORRHOIDS:-

  • GRADE 1:- Painless bleeding, no prolapse.

  • GRADE 2:- Prolapse on defecation that reduces spontaneously.

  • GRADE 3:- Prolapse that has to be reduced manually.

  • GRADE 4:- Permanent Prolapse.

External hemorrhoids:- form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops because the clot can block blood flow. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

These are under the skin around your anus. Signs and symptoms might include:

  • Itching or irritation in your anal region

  • Pain or discomfort

  • Swelling around your anus

  • Bleeding

Thrombosed hemorrhoids:- A thrombosed hemorrhoid happens when there is a blood clot inside hemorrhoid, a swollen vein in the anus or rectum. The blood clot blocks blood flow, causing painful symptoms.

Most thrombosed hemorrhoids are external, but they can also be internal. External hemorrhoids form in the tissue outside the anus, whereas internal hemorrhoids are inside.

Thrombosed hemorrhoids are also known as acute hemorrhoidal disease or perianal thrombosis.

Thrombosed hemorrhoids may appear as a single lump or a circle of lumps.

COMMON SYMPTOMS OF HEMORRHOIDS:-

  • bright red blood after you poop.
  • an itchy anus.
  • feeling like you still need to poop after going to the toilet.
  • mucus in your underwear or on toilet paper after wiping your bottom.
  • lumps around your anus.
  • pain around your anus.

TYPES OF HEMORRHOIDS:-

There are 2 types of treatment for Hemorrhoids 

  1. Non-surgical

  2. Surgical  

Non-surgical PROCEDURE :-

Non-surgical includes procedure for treating the hemorrhoids 

Rubber band ligation :–  It is a procedure in which elastic bands are applied onto internal hemorrhoids at least 1 cm above the pectinate line to cut off its blood supply. Within 5–7 days, the withered hemorrhoid falls off. If the band is placed too close to the pectinate line, intense pain results immediately afterwards. The cure rate has been found to be about 87%, with a complication rate of up to 3%.

Injection (sclerotherapy) – Involves the injection of a sclerosing agent, such as phenol, into the hemorrhoid. This causes the vein walls to collapse and the hemorrhoids to shrivel up. The success rate four years after treatment is about 70%

Infrared photocoagulation – A doctor uses a tool that directs infrared light at the internal hemorrhoids. The heat created by infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking hemorrhoids.

Electrocoagulation –  This method is almost similar to infrared photocoagulation, but instead of using infrared coagulation here Electric current is used to create scar tissue and cut off the hemorrhoids’ blood supply.

TREATMENT:-

Here following are the surgery types for hemorrhoids:- 

Hemorrhoidectomy:- During surgery, incisions are made around the hemorrhoid with a scalpel, cautery pencil (heat-generating electrical instrument), or laser. The swollen veins in the hemorrhoid are tied to prevent bleeding. The surgical wound can be left open or sutured. A medicated gauze is applied to the wound.

Hemorrhoidal Artery Ligation Operation (HALO): This procedure is effective in case of larger hemorrhoids and where simpler procedures have failed. An ultrasound probe is used to locate the hemorrhoidal blood vessels, which are sutured to stop the blood supply to hemorrhoid. This procedure is usually done along with Recto-Anal Repair (RAR), hence it is also termed HALO-RAR.

Prolapse and Hemorrhoids (PPH):- PPH is also commonly referred to as a stapled hemorrhoidectomy, stapled hemorrhoidopexy or circumferential mucosectomy. This treatment option is the most commonly used surgical remedy for third-degree hemorrhoids.  P.P.H. may also be used in cases where medical management has failed in stage two diseases and is also used in stage four diseases. This procedure removes the abnormal portion of the hemorrhoid while returning a portion of hemorrhoid to its prior normal location within the rectum.  It is thought that this residual replaced hemorrhoidal tissue will continue to act as a cushion for bowel movements.

New Techniques: The newer techniques involve modern strategies to remove the hemorrhoidal tissues. 

Harmonic scalpel excision is one such method where ultrasound waves are used to cut and seal blood vessels leading to and from the hemorrhoidal mass. This technique is used for large hemorrhoids and where bloodless surgery is required. A laser can be used to cut through the tissues with simultaneous cauterization, thereby sealing off any blood vessels. Atomization is one of the latest techniques where a vacuum is used along with an atomizer that breaks down and sucks up the hemorrhoidal tissue mass.

RECOVERY TIMELINE:-

  • Most patients start to feel better at the end of the first week. 
  • This is especially true if you can keep your bowel movements soft or slightly loose. Pain will be much worse if your stool is hard or if you have to strain to have a bowel movement.
  • Try to avoid constipation while you recover. If you usually take constipation medication, you may need a different strategy to prevent constipation while you recover.
  • Most people are able to resume non-strenuous activities a week after treatment. You should be able to resume all normal activities within two to three weeks.