1. Piles ( or Haemorrhoids - pronounced "hem-or-oids")

2. Fissure

3. Abscess

4. Fistula

5. "Other Problems"

PILES: Piles are usually painless. They cause bleeding without pain during passage of stool , and may produce one or more lumps near the anus. These lumps contain swollen blood vessels and blood. Piles are caused by excessive straining (holding one's breath and pushing) during the passage of stool or by constipation. They are not caused by "hot foods" or by hot weather or by sitting for a long time in a car, scooter or bus seat. Excessive loss of blood from piles may lead to anaemia.

FISSURE: A fissure is a wound in the sensitive skin of the anus. Such a wound is usually caused by hard stool. It is a very painful condition and may cause bleeding or a painful lump. It is not caused by "excess heat". The hot spicy foods may aggravate the pain.

ABSCESS: This is a collection of pus - it is essentially a boil next to the anus. It is very painful and may produce a lump. It is not caused by heat, hot foods or hard motions.

FISTULA: This is an abnormal channel between the inside of the anus and the skin outside. It causes pain and pus discharge.

OTHER PROBLEMS: These conditions are often wrongly referred to as "piles" because they produce bleeding or pain but the actual cause may be some very serious diseases requiring urgent treatment. These include Ulcerative Colitis or cancer

DIAGNOSIS: None of the five conditions mentioned above can be diagnosed without properly examining the anus. Avoiding this sometimes leads to severe complications. It may also be necessary to look inside the anus with a small telescope. This procedure is called either a "Proctoscopy" or "Sigmoidoscopy" depending on the type of instument used.

TREATMENT:

PILES:Piles in the early stages can be controlled by avoiding constipation and "straining" (holding of breath and pushing while passing stool). Unfortunately people who suffer from severe bronchitis, asthma or prostate trouble may not be able to avoid straining.

Bleeding piles may be treated by simple and painless treatments such as injection or "Banding".

Large piles require removal by operation .

TREATMENT OF FISSURE: Fissures be cured by medication to make the motions soft. If this fails a small operation is sometimes required.

ABSCESS: The only cure is to have the pus removed by a small operation. Occasionally the abcess may burst by itself - which may result in a spontaneous cure, or occasionally, a fistula may result.

FISTULA: Cure of a fistula is sometimes difficult and may require one or more operations

Avoidance of Constipation: Constipation may be avoided by eating plenty of fruits and vegetables every day or by taking extra fibre in the diet which helps to soften the motions. It is also important not to hold back motions and postpone going to the toilet. This can cause constipation. Constipation cannot be avoided merely by drinking a lot of water or fluids.

Operation For Piles And Other Conditions:

1. They usually require admission to hospital for two to five days depending on the condition.

2. A "spinal" anesthetic is often used, so there is no pain immediately after operation - though ther may be some pain later, which can be relieved by appropriate medication.

3. Blood transfusion is not required.

4. The patient is allowed to eat within a few hours after the operation.

5. There is no need to avoid passing stool after operation. The stools are often easier after surgery.

6. A rest period of one to two weeks may be required after the operation.

7. Recurrence of piles: Piles can recur after many years if constipation and straining continue.In addition, a patient who has been treated for piles may get some other problem such as an abscess or a fissure which may be mistaken for piles.

Please email me if you have any doubts or questions.