Complications rise among piles patients in shutdown

Complications rise among piles patients in shutdown

A sizable number of people with piles and fistula are taking longer to get cured as most of them are delaying medical care in the wake of the coronavirus triggered lockdowns, resulting in complications.

“Usually, 70% of patients with piles are treated with medicines and dietary changes as they get diagnosed in an early stage. However, owing to the extended lockdown in the wake of the Covid-19 pandemic, a sizable number of patients are presenting in late stages of the disease with symptoms like severe pain and bleeding,” said consultant colorectal surgeon Ashwin Porwal of Healing Hands Clinic.

Once the haemorrhoids (piles) are in grade III or IV stages, medical management has a limited role.

“Most of these patients with progression of piles are being treated with laser surgery when medication and lifestyle modifications could have been enough to do the trick if they had approached us early,” Porwal said.

Similarly, patients with an anal fissure, a small tear or crack in the lining of the anus, who normally respond to medications in two weeks are now taking a minimum of 4-6 weeks for recovery with medications. “Patients with fistula, a tunnel that runs from inside the anus, are also approaching us after developing severe pain or fever due to abscess (collection of pus). Quite a few of them even required emergency surgery,” Porwal said.

Many of the outstation patients who were operated in early March (before the lockdown) for complex fistula couldn’t come for follow up due to the lockdown.

“They developed premature closure of the wound, which developed into pus leading to an abscess. This would not have happened if the follow-up dressing was not skipped,” laparoscopic surgeon Deepak Kulkarni said.

Healing is slow in such patients even after surgery.

“Patients need weekly follow up after surgery. But the frequent lockdowns made them reluctant to venture out for follow up, delaying the healing and recovery,” said anaesthetist Nitin Nachane.

Contracting Covid-19 from infected but asymptomatic patients is always a risk for healthcare workers as much as other patients.

“To minimize this, strict universal precautions are being taken. Post-surgery, patients are put on immunity-boosting medications like Curcumin and vitamin D for two weeks. None of our patients have developed Covid-19 during hospital stays and even after the surgery so far,” Porwal said.

Experts also stressed against indulging in self-medication amid Covid-19 infection fears.

“It is always better to reach out to the medical practitioner via online or video chats or simple call,” an expert said.

Reference

Pruritus Ani: The Embarrassing Itch

Itching of the skin around the anus can be agonizing especially if one is stranded in a public place with no escape in view. More often than not the cause behind this itch is easily addressed. Occasionally however, persistent severe itching can cause psychological stress to the sufferer and needs in-depth evaluation.

What is Pruritus ani?
Pruritus ani is defined as chronic, moderate to intense itching of the skin around the anal opening.
It affects 1-5% of the population and is more commonly found in men. Once itching occurs, it can lead to a vicious itch-scratch-itch cycle.

Causes of Pruritus ani

Fecal Contamination

Prolonged contact of the skin with fecal matter can cause irritation with resultant pruritus. Inadequate cleansing can leave stool and sweat residue which acts as irritant. Most of these individuals have loose stools or mucous seepage. Abnormal anal sphincter relaxation can also cause soiling. This kind of itch is usually relieved by washing the area. However, underlying pathology, if any, needs to be addressed.

Anorectal disorders

Anorectal conditions like Hemorrhoids (Piles) and Fissure can precipitate peri-anal itch. External hemorrhoids that are large can interfere with post-defecation cleansing. Internal hemorrhoids, on the other hand, can cause mucous seepage or fecal soiling and resultant pruritus. Anal Fissures can also cause itching due to inflammation. Anal Fistula or Fistula-in-ano with an external opening in the region, can lead to discharge of pus or fecal matter and consequent itching.

Infections

Fungal infections are common in the area, especially among diabetics who are prone to Candidiasis. Infection with threadworms/pinworms is also common, especially among children. Viral infections can also cause pruritus

Allergy

Chemicals found in creams, wet wipes, soaps etc. can cause Allergic Contact Dermatitis.

Skin conditions

Psoriasis, lichen sclerosis, Paget’s disease, peri-anal Bowen’s disease etc. can also can pruritus ani.

Other factors

Certain foods like caffeinated drinks, spices, peanuts, tomatoes etc. can cause peri-anal itching. Relief is attained within 2 weeks of stopping the causative food.
Aggressive cleaning can cause dryness of the skin and thus itching.
Psychological factors like anxiety, stress or depression maybe associated with pruritus ani.
Similarly, aggressive cleansing can cause dryness in the area and itching.

Dealing with Pruritus ani

To get rid of peri-anal itching, the underlying cause needs to be addressed. One should wear loose, cotton clothing, especially at night, which gives an opportunity for ventilation. Following a bowel movement, the area should be gently cleaned with water or simple tissue moistened with water or with peri-anal wipes. One should avoid the use of soaps in the area. Associated symptoms, if any, point to an underlying pathology. Anorectal conditions like piles, fissure and fistula are treated by a Proctologist. Peri-anal skin conditions, infections and allergies are treated by a Dermatologist.

What you need to know about Piles

About Piles

Studies suggest that by age 50, about half the population has experienced one or more symptoms of Piles. These include itching, bleeding on passing stools, pain and prolapse (where a mass is felt in the anal area). Piles aka Hemorrhoids can significantly disturb well-being of an individual.

Causes
● Long standing constipation
● Hard stools
● Pregnancy
● Excessive straining during defecation
● Chronic cough

Hemorrhoids are swollen veins of the rectum and anus. When veins of the lower rectum swell, they are called Internal Hemorrhoids, which are typically associated with painless bleeding. When the swelling occurs in veins under the skin around the anus, they are called External Hemorrhoids and cause considerable discomfort.

Proctology is a specialty of medicine that deals with conditions like piles, fissure, fistula, constipation, pilonidal sinus etc. Healing Hands Clinic founded by Dr Ashwin Porwal aims to provide cutting-edge treatment for these conditions. Hemorrhoids are treated depending upon their grade. Grade 1 which is the earliest stage is treated holistically by MCDPA, which is a combination of herbal medicines, pelvic floor physiotherapy and dietary changes. Grade 2 and 3 are associated with mass coming out of the anal opening which goes back spontaneously or with manipulation respectively. These grades are treated using Diode Laser by a technique called Laser Hemorrhoidoplasty. Laser provides a quick, effective and safe treatment option. When the disease reaches grade 4, the protruded mass (prolapse) remains outside the body. At this stage, Stapler Hemorrhoidectomy is done. Stapler surgery ensures complete removal of protruding mass and leaves no chance for recurrence. When done by an expert, these procedures don’t harm the anal sphincter, thus control over motion remains intact. Patient can go home within 24 hours and get back to routine work by 3rd day.

For appointments:
Healing Hands Clinic
Pune Station / Tilak Rd: 88882 88884
Kondhwa: 88885 22226
Baner: 88886 22221
Chinchwad: 88882 00004
Chakan: 88882 96666
Kothrud: 8888988882
Website: www.healinghandsclinic.co.in
Email: info@healinghandsclinic.co.in

Don’t Confuse Fissure with Piles

Don’t Confuse Fissure with Piles

For most of us any problem in the anal region is either piles or fissure, the self-diagnosis usually depending upon which of the two words is ingrained in our vocabulary. However, a goofed-up diagnosis not only adds to the misery but makes a simple problem complex. I have tried to explain the difference between the two in simple words here. When it comes to one’s health, its best to be well-informed and aware of the condition one is faced with.

What is the difference between piles and fissure?

Piles or hemorrhoids are swollen blood vessels near the anal opening whereas fissure is a tear in the delicate skin of the anal opening. Depending upon the severity of the disease, piles are graded from 1 to 4, grade 1 having just swollen vessels while grade 4 has a mass comes out of the opening.

What is the difference in symptoms?

The predominant symptom of a fissure is intense pain while defecating. The magnitude of the pain is such that one fears going to the toilet.
Piles are usually characterized by bleeding after passing stools. The blood is fresh and there is no pain. Sometimes one may feel a mass at the anal opening.

Which tests are needed for a diagnosis?

A history of symptoms and visual examination is enough to diagnose fissure. In addition to above, a simple painless technique called Proctoscopy is done in case of hemorrhoids, for a more accurate diagnosis and grading.

Can these conditions be permanently treated?

Modern medicine assures a reliable, quick and effective cure of anorectal problems. Medicines, dietary modifications and lifestyle changes (MCDPA) are enough to treat early piles and acute fissure. In case of chronic cases of fissure, Laser Sphincterotomy provides excellent results. Similarly, for higher grades of piles, Laser Hemorrhoidoplasty (LHP) or Stapler surgery (MIPH) provide a safe, minimally painful and efficient modality of treatment. The earlier techniques weren’t as developed and recurrences were a problem. But with these advanced procedures hemorrhoids can be cured for good.

Have Piles? Shed the Shame

Our culture has a huge impact on how we think, what we choose to speak about and what we leave unsaid. It’s little wonder then, that most of us, especially women are shy when it comes to speaking about certain conditions like piles, constipation or prolapse that involve private parts. We choose to suffer in silence rather than coming forth and seeking help. Being the wife of a Proctologist, I often get to hear stories of how women have remained closemouthed for years until the disease has flared up to alarming complications.

Although we have tried to spread awareness and encourage women to shed their inhibitions, we have observed that there are quite a few who are still reluctant to come to us for a consultation, despite Healing Hands Clinic being the most advanced Proctology (branch of medicine that deals with diseases of the rectum and anal canal like piles, prolapse, constipation, fissure, fistula etc.) center.

Women often want a female doctor to consult with, especially for such conditions. Being a doctor myself, and having been brought up in a very ‘Indian’ culture, I understand both sides of the coin. However, all the wisdom in me reiterates that it is far more important to go to the doctor with the best knowledge of the disease, rather than settle for a doctor of a particular sex just because my mindset and culture conforms to it. Having said that, we ensure that no matter who the consulting doctor is, the presence of female assistants is a prerequisite for examination of female patients. EVERY FEMALE PATIENT IS MADE EXTREMELY COMFORTABLE DURING CONSULTATION, RESPECTING HER DIGNITY IS OUR TOPMOST PRIORITY DURING EXAMINATION. We have hundreds of happy female patients from every culture and every strata of society, and it is a matter of pride for us to have served them within their confines of decency.

This is to all you women out there; Leave behind the reticence, it’s your body, stand up for it. There is no shame in speaking to your doctor. Man or woman, we all have all sorts of health issues, and we all deserve the best care for it. So take the first step towards respecting your body and opt for the best medical care.
Like we urge to one and all; HAVE PILES? SPEAK UP.

At Healing Hands Clinic, we have best lady doctor for piles in Pune, Mumbai,
Nashik and Bengaluru centers.

Home Remedies For Piles

piles treatment in baner, piles treatment in navi mumbai

Piles (Mulvyadh/Bavasir), clinically known as haemorrhoids, is a very common lifestyle disease. Haemorrhoids are mainly a result of following wrong habits. So before looking for medical remedies, one should assess one’s own lifestyle and seek answers to a few questions:

1. Do you drink enough water throughout the day to keep yourself hydrated?

Minimum of 3 litres of water must be consumed daily in order to stay hydrated.
2. What kind of food do you consume? Is it healthy and rich in fibre?

Green leafy vegetables and fruits should be consumed for improving fibre intake.
Consume complex carbohydrates such as whole grain or multigrain cereals and avoid refined cereals.
Limit spicy food.
Say no to fast food and packaged food.
Increase the intake of vitamin C (Citrus fruits can be consumed for the same).
Avoid excessive sugar intake.
3. How often do you exercise?

Exercising is great for health, stay fit! You can do yoga, walking, jogging, cycling, swimming etc. for a minimum of half an hour daily. In fact, certain poses in Yoga are specifically directed towards preventing piles and other rectal problems.
4. Do you use your smart phone or newspaper in your washroom?

It might seem like a strange question, but using your cell phone in the washroom may divert your mind from what needs to be done. The distraction might lead you to spend more time on the toilet seat, increasing the pressure on the veins in the pelvic region. By doing so you are giving way to haemorrhoids (piles)
A little bit of above introspection and making a few lifestyle changes will help you steer clear of piles and prevent any recurrence if you have already been a victim. Unfortunately, if you are already one amongst those suffering from haemorrhoids, some simple home based remedies can be very handy. They may not be a permanent solution, but will provide you temporary relief until you seek advice from a Proctologist.

1. Ice : Applying an icepack will reduce the pain and inflammation by compressing the blood vessels. Apply the icepack for 10 – 15 minutes in the affected area 4 times daily.

2. Citrus Fruits : Intake of citrus fruits can help in strengthening the capillaries and blood vessel walls.

3. Hydrate yourself : Reduced water intake causes constipation which further aggravates haemorrhoids.

4. Avoid friction : Do not wipe the affected area repeatedly with a dry tissue as it can cause friction and irritation and can worsen the condition of the swollen vessels.

5. Sitz Bath: You can sit in a tub of lukewarm water for a period of 15 to 20 minutes. This will help reduce the pain and swelling and will keep the area hydrated for some time. Doing this is definitely recommended and can be done regularly.

6. Olive oil: Olive oil has anti-inflammatory properties. Applying a little oil acts as a soothing agent and helps reduce the discomfort by increasing the elasticity of blood vessels. This in turn helps in relieving pain while passing stools.

7. Ghee (Clarified butter): Consumption of 2 teaspoons of pure cow’s ghee every morning will help improve bowel function and act as a lubricant.

8. Aloe Vera: The anti-inflammatory and therapeutic properties of aloe vera make it the best natural treatment for haemorrhoids. You could use it for both external and internal haemorrhoids.
Internal Haemorrhoids – Clean the Aloe Vera and cut it in strips down the middle to reveal the gel. Get rid of the thorns, and place the strips in a container to freeze for some time. Gently and carefully, apply the gel side of the frozen strips on the affected area to get relief.
External Haemorrhoids – Take Aloe Vera gel and apply it on the haemorrhoids and massage gently. This will give you relief from pain, itching, burning sensation and irritation.
Kindly note that although these remedies may give you short-term relief from your symptoms, they won’t treat or cure your piles.
Then what are the treatment options for Piles…??? To know click here…

May you have a smooth transition from piles to smiles!

I CHOSE TO SPEAK UP AND FACE IT

Are you shy of going to a doctor and talking about that problem you have in your bottom? Yes? Quite obviously, most of us are hesitant to open up about our diseases, especially the ones relating to our derrière. We end up bearing the pain hoping positively that sooner or later it will vanish on its own.

Unfortunately, that’s far from the truth, because I have learned from my own experience of ‘a pain in the ass’ that ignoring anorectal problems (that’s the fancy word for them in medical terms) like piles, constipation, fistula or fissure may eventually end up piling one problem over another. That’s because most of the times these diseases are interlinked. For instance, ignoring my constipation for too long can leave me with piles. Blood in the pot, excruciating pain while defecating , pus leaking out of the bottom, itching or burning near the anus to the extent of not even being able to walk properly are some of the horrifying symptoms of these diseases.

Not only do these problems affect you physically but they also make you feel isolated and lead to a big full stop to social life. How do I know this? Well, that’s because I have been a victim of one of these diseases and my shy nature inhibited me from seeking help. As luck would have it, I joined a well known centre called Healing Hands Clinic which is basically a speciality clinic for anorectal disorders. Until I joined here I lacked awareness about these diseases.

In fact even after working here and becoming more aware, I was afraid of sharing my problem with any of the doctors. But then there came a week with terrible pain which I couldn’t handle. I told my family members about the problem I was facing and they encouraged me to seek help. I finally opened up about my problem to Dr Ashwin Porwal (yes, he’s my boss!), and after a thorough check-up he diagnosed me with External Thrombosed Piles. Sounds scary! But Dr Porwal calmed me down and told me that it would be a minor procedure and I would be going home riding my bike in the next 2 hours. Honestly, I faced no pain during the surgery and after an hour and half I went home riding my bike free of pain. In fact I was back to work the next day itself, the only difference being I was a happier piles-free version of my previous self.

The reason I chose to speak about my experience is that I want to spread out a message to everyone that it’s time to say ‘NO’ to pain! Take your heads up and face it . Don’t be shy, speak up. It will bring about a change , a positive change that will change the way your day begins.

So lets say ‘ NO TO PAIN , AND SPEAK UP’. Lets spread awareness and encourage those who live with a problem they can easily choose to solve.

Do Not Ignore Anorectal Bleeding

Anal fissures & Piles are not exactly a topic for cocktail party conversation, and the reluctance to discuss them often leaves sufferers thinking they are the only ones affected. In fact, this potentially painful, debilitating, anxiety-provoking condition is quite common.

“Every bowel movement was painful with bleeding, and the agonizing after-spasms went on for hours,”. “Even when I wasn’t in actual pain, it was all I could think about. My work suffered; my life was on hold.” This is every piles & fissure patients story!

If you’ve ever noticed bright red blood after a bowel movement, chances are it is a small tear in the rim of the anus called as aFISSURE. Such tears are commonly mistaken for hemorrhoids, which unlike fissures don’t cause pain with bowel movements. In an estimated 90 percent of cases, these tears heal on their own. If they don’t then they can be treated within a day with Leonardo Laser that has been recently introduced by Healing Hands Clinic, Pune.

Hemorrhoids( PILES ) are veins in the rectum that have become swollen and painful. Sometimes they go away by themselves, but in other cases they cause lingering pain, heaviness, itching, and bleeding which can be cured with medicines and in severe stages causes an irreducible prolapse which will require surgical intervention ( Laser for initial stages & Stapler Surgery for severe stages ).

Similarly,Solitary rectal ulcer syndrome ( SRUS ) is a rare and poorly understood disorder that occurs in people with chronic constipation. This can cause rectal bleeding and straining during bowel movements. Treatments for solitary rectal ulcer syndrome range from changing your diet and fluid intake to surgery.

Colitis also presents with bleeding in stools. It is inflammation of the inner lining of the colon. It may cause abdominal pain and diarrhea with or without blood. Fever may be present. The treatment of colitis depends upon the cause.Initial therapy, regardless of the cause is to stabilize the patient’s vital signs and helping control pain, if needed.

To conclude, anorectal bleeding should not be ignored and must be checked immediately on priority from a Proctosurgeon or Colorectal Surgeon. Healing Hands Clinic founded by Dr AshwinPorwal and led by team of Surgeons, Nutritionists & Physiotherapists is one such Proctology Centre across the country that has treated more than 40,000 patients from anorectal ailments! Healing Hands Clinic has introduced Leonardo Laser for the first time in the country for Treatment of Piles , Fissures , Fistula , Pilonidal Sinus & Varicose Veins.Dr Porwal recently presented his work on highest series of Stapler Surgery for piles & STARR for constipation in Asia at European Society of ColoProctology.