Piles

• General measures (Home Care) for piles

• Medical management

• Painless minimally invasive procedures for piles treatment

• Injection and sclerotherapy

• LASER, Infrared or coagulation

• DG HAL & HAL-RAR: FDA approved safe and painless procedure for piles

• MIPH (stapler surgery) for piles

• Open piles surgery (Hemorrhoidectomy): – when ligation fails, bleeding is persistent, & protruding hemorrhoid can not be reduced.

• Anal Hygiene: Proper Cleaning techniques
  Avoid rubbing with toilet paper. This aggravates the hemorrhoids and irritates the skin.
  Rinse the area in a bath or a shower without using soap. Then gently dry the area by blotting it with a towel.
  Alternatively disposable baby wipes can be a used for gentle cleaning when bathing is impractical.
  Moist anal area is prone to irritation and infection so keep it dry. Sprinkle baby powder or place large cotton pad to absorb any moisture.

• Bowel Movement
  Use the toilet as soon as you feel the urge to have a bowel movement, even if it is several times throughout the day. Do not delay as you might get a reflex constipation.
  Avoid prolonged sitting or excessive straining while on the toilet; Limit your time 3-5 minutes for any one sitting. If you can’t have a bowel movement in that time, come back later.
  Don’t read, watch TV, talk on the phone, or play video games while sitting on the toilet.

• Diet
  Take High Fiber Diet beans, whole grains, bran cereals, fresh fruits, and vegetables.
  Limit food that have little or no fiber such as ice cream, cheese, meat, and processed foods.
  Avoid soda beverages, citrus fruits and juices, beer and wine, and caffeinated products.
  Drink 8-10 glasses of water, exercise regularly.

• Enemas
  Enemas may be used to relieve constipation and fecal impaction. To keep the bowels clean, plain warm water enemas can be effective.

• Ice Packs
  Apply an ice pack to the anal area on and off for 10-15 minutes for inflamed piles.

• Hot Sitz Bath
  Fill up your bathtub with warm water and sit in it for 10-15 minutes.

• Topical Ointments and Creams
  Petroleum jelly can be applied to the anal area to soothe irritated skin surfaces.
  Applying ointment to the anal passage just prior to a bowel movement can help alleviate pain caused by the passage of a hard or difficult stool.

• No cutting and no open wounds
• Short procedure time
• Only one day in hospital
• Back to work the next day
• Very high success rates worldwide

• On the day of you will be given enema or suppository for bowel preparation.

• You will not be allowed to eat / drink 6 hours prier to surgery.

• You may have soft pad in place but no internal dressing

• You will be allowed to drink when you are fully awake.

• Usually no pain medication is required.

• You may feel the need to defecate frequently throughout the first 24 hours.

• There’s usually little or no postoperative bleeding, and return to work within 48 hours.

• Diet- Eat diet reach in fiber, drink 8-10 glasses of water.

• Activities- You can resume your routine activities and work same day. Avoid driving for 24 hours.

Limitation:

Stapler Hemorrhoidectomy:

• Shower-spray the anal area with warm water the morning following surgery.

• Perform sitz baths twice each day and after each bowel movement (10-15 minute soak in warm water).

• For prolonged sitting, use a pillow or styrofoam pad.

• Take 1 tablespoon of fiber supplement once each day. Dissolve this in a glass of water or juice. Drink 8-10 glasses of water per day.

• Pain Medication if required can be taken

• Rest for the day. Avoid heavy lifting or vigorous exercise for 5 days.

• You can have a regular high fiber diet

• Straining due to constipation should be avoided; you should not sit longer than two minutes on the toilet. If you can’t have a bowel movement in that time, come back later.