All You Need to Know about Pilonidal Sinus

“Pilonidal Sinus“ is an Italian term, which means a nest of hair, highlighting the main cause of the disease – ingrown hair. It’s a less known ailment but is common among young generation, especially males between an age group of 20 to 30. A pilonidal cyst is a cystic structure developed along the coccyx region (tailbone) in the cleft of the buttocks, located almost 4-5 cm from the anus. This cyst is filled with hair, bacteria and skin debris.

Common Symptoms

More than one cyst may also develop, which later connect to each other by tunnels formed under the skin. It eventually forms an abscess. A patient suffers from a lot of pain and soreness in the particular body part. Even after pus discharge from the cyst, it continues to fill up with detritus leading to re-infection. One must see a Colorectal Surgeon well before the sinus becomes severe. If the cyst is infected, then pus is drained out and the patient experiences fever, pain & swelling in lower spinal region and warmth & redness in the affected skin.

There may not be any noticeable symptoms indicting the occurrence of a pilonidal sinus. As soon as a small dimple-like depression is developed on the skin in natal cleft, one should immediately seek for a doctor’s assistance. This dimple-like depression is infected later to develop into a cyst filled with abscess.

Males are most likely to suffer from pilonidal sinus. Let’s see what the risk factors are.

Family history
Profession demanding prolonged sitting or driving
Copious hair (hirsute)
Deep natal cleft

A pilonidal cyst is diagnosed by physical examination and prominent symptoms.

Pilonidal Sinus Treatment

If not infected, pilonidal sinus can be cured by medication. However, an infected sinus has to be treated by a surgery. Conventional surgery is performed under local anesthesia to remove all the debris and abscess from the cyst. However, recurrence is common, as it is estimated to occur in approximately 40%-50% of individuals. At Dr. Ashwin Porwal’s Healing Hands Clinic, Excision & Primary Closure are provided for successful pilonidal sinus treatment in and around Pune.

Maintaining hygiene in the sacrococcygeal area is critical to prevent pilonidal sinus. Keeping the area clean, dry and free of hair is the best preventive measure.

Treatment for Varicose veins

Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That’s because standing and walking upright increases the pressure in the veins of your lower body. For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern.

For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems. Diagnosis of varicose veins includes physical examination by your doctor. And if required and prescribed by your doctor you will be asked to undergo a small test known as Ultrasound for further diagnosis.

This test is used to check if valves in your veins are functioning normally or if there’s any evidence of a blood clot. Taking corrective actions on time for treatment of varicose veins is necessary else it may lead to severe conditions.

There is a myth that treatment of varicose veins involves surgery as the only option but these are not true. There is self care as an option for early varicose veins treatment. The self care involves exercising, losing weight, not wearing tight clothes, elevating your legs, and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse. And if this does not work there is a stocking available in market for treatment of varicose veins.

Compression stockings are worn all day. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently. But getting the right size is very important hence consult a doctor first and then only move ahead.

There are surgical option also for severe varicose veins conditions like Sclerotherapy, Catheter-assisted procedures, Vein stripping, Ambulatory phlebectomy, Endoscopic vein surgery & many more.

But opt for Laser treatment for varicose veins which only requires 24 hours stay and a faster recovery rate.

Healing Hands Clinic is an Member of ECTA(Biennial Eurasian Colorectal Technologies Association), ESCP(European Society of Coloproctology), and ISO Certified. Dr. Ashwin Porwal & Dr. Paresh Gandhi are well known Varicose veins surgeon in Pune. Dr. Ashwin Porwal is a leading Consultant Colo-Procto Surgeon in Pune and HOD Proctology with Apollo Jehangir Hospital, Inamdar Hospital, Poona Hospital, Ruby Hall Clinic where he has successfully treated

most of his varicose veins patients and brought back their smiles with painless laser surgery for varicose veins treatment. Dr. Paresh Gandhi is a successful General Surgeon who has been performing large number of Three Dimensional Mesh Repair for Hernia in Pune, with expertise in hernia surgery without stitches & also well known for Varicose veins surgery in Pune.

Both Dr. Ashwin Porwal & Dr. Paresh Gandhi have a great in depth & experience on treatment for varicose veins.

Painless Piles Treatment

People are hesitant to openly discuss some topics in descent conversations; Piles is one such topic. Piles (Haemorrhoids in clinical terms) are commonly known as ‘Mulvyadh’ and ‘Bawaseer’ in vernacular terms. Since the ailment is associated with anorectal part of the body, most people tend to avoid visiting a doctor for primary symptoms such as anal itching, pricking, hard stools, fingering during passing of motions bleeding during bowel movements, and pain. But don’t be a silent sufferer, show to Piles doctor for your concerns. As it is rightly said prevention is better than cure. Meeting Piles doctors or a Piles surgeon can help you solve and overcome health issues.
There are many piles doctors in Pune, one of them is Dr. Ashwin Porwal a renowned Piles Surgeon in Pune. Dr. , Founder of HHC, Dr. Ashwin Porwal, is the best doctor for piles (Mulvyadh/Bavasir) operation in pune specializes in STAPLER Surgery, which cures Piles (Mulvyadh/Bavasir) permanenetly and assures least recurrence possibility. Ashwin Porwal is joined by a cadre of surgeons, physicians & nutritionists who are committed to “CURING WITH CARE”. As a top-notch Proctology Clinic (Piles (Mulvyadh/Bavasir), Constipation, Fistula, Prolapse & Fissure) in India, our care spectrum also extends to chronic diseases prevalent in the society today. From preventive measures to palliative care, our services pay due attention to every aspect of patients well-being. Dr. Ashwin is founder of Healing Hands Clinic, Pune. Healing Hands Clinic specializes in the management of anorectal diseases (Piles (Mulvyadh/Bavasir), Constipation, Fistula, Rectal Prolapse, Pilonidal Sinus) Hernia, Digestive Diseases & Varicose veins via both surgical and medicinal management methods.
Till a few years ago, the most popular piles (Mulvyadh/Bavasir) treatment has been the conventional piles (Mulvyadh/Bavasir) surgery, which treats them temporarily but does not assure to eliminate prolapse and cure permanently. Healing Hands Clinic has come up with an ideal, holistic approach to cure Piles, the most common lifestyle diseases affecting anorectal health of individuals. Starting with the combination of MCDPA – medication, constac (herbal laxative), diet & lifestyle modification, physiotherapy and Ayurveda, we escalate to complex treatment procedures, as the disease advances to severe stage. Other than this non surgical, we also provide surgical options which are painless procedure. Healing Hands Clinic, a piles clinic in Pune also offers, painless piles treatment procedure known as Stapler Surgery & latest laser surgery. With these method patient can be treated with only 24 hours of hospitalization. These methods involves blood free environment, less pain, no stitches, etc. Post-surgery also there is negligible pain and after 3 days patient can join the duty also.

Water an effective ingredient in Constipation treatment

Constipation is generally described as having fewer than three bowel movements a week. If treatment for constipation is not done on time it may lead to chronic constipation. Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. To be more specific, if still not taken care, constipation contributes to Piles (haemorrhoids) hence treatment for constipation on time is very necessary. Piles (Haemorrhoids) are painful, swollen veins in the anus and rectum which might trouble you during your pregnancy.

Many people avoid speaking about such issues/problems which they suffer from due to shyness, which is a human tendency. But don’t be a silent sufferer & get consulted to piles doctors as soon as you start observing changes in your daily bowel habit. There are many home remedies also available for constipation treatment. Are you aware of effectiveness of water in treatment of constipation? Water is very necessary to overcome constipation problem. The main problem of constipation is hard stools due to fewer intakes of fiber food or liquids or irregular eating habits. Water is important for your digestion. It keeps the food you eat moving along through your intestines and it keeps your intestines smooth and flexible, too. The more fluid intake the more is hard stools soft. Fruit and vegetable juices, clear soups, and herbal teas are also good sources of fluids. Over all this one point that an individual must understand is extra fluids help keep the stool soft and easy to pass, but drinking more liquids does not cure constipation.

Therefore, get consulted from an expert about your constipation treatment. Or even about your diet chart. Healing Hands Clinic (HHC), Pune is a well known hospital for constipation in Pune. Dr. Ashwin Porwal is the founder of Healing Hands Clinic & a renowned Colo-Rectal Surgeon in Pune. Healing Hands Clinic has started its journey from one small clinic in swargate but now enlarged its arms from Pune to Jaipur to Navi Mumbai with its franchises. There is an expert team available for your cure on constipation free pregnancy. There is an in house dietician & doctor’s team present at HHC to serve you to complete your joy of pregnancy with no tensions on constipation.

The more you follow your diet and exercise on daily basis you are away from your constipation problem. Hence, don’t bear your problem in silent but get consulted to a colo-rectal surgeon for faster recovery.

Innovative Treatment for Fistula

Many a times unless we suffer from a certain diseases we never get an idea of that disease. And even if we get through that symptom sometimes we don’t understand through which phase of diseases we are suffering from. Similarly, Anal Fistula (Bhagandar) is one of the ailments that most of the people suffer from but are not aware. Anal Fistula (Bhagandar) is an abnormal communication between the anus and perianal skin. Most anal fistulas are the result of an infection in an anal gland that spreads to the skin. The common symptoms of Fistula are extreme anal pain, Non-healing anal wounds, discharging boils formed near the anus, Pus & watery discharge along with fever and chills.

Based on the symptoms of fistula, it is diagnosed by Proctoscopy or MRI Fistulogram. Based on your medical reports, your doctors will advise you to undergo one of the following treatments:

1. VAAFT- Also known as Video Assisted Anal Fistula Treatment. It is an innovative technology for selected fistula cases only.

2. Ksharsutra- It is a traditional ayurvedic therapy.

3. Fistulectomy- The fistula tract is totally taken out using an advanced radiofrequency device under a strong light source.

4. FiLAC- It is known as Fistula Laser Closure. It’s a procedure performed with the help of the Leonardo Laser Device that gently and effectively cures the anal fistula and also prevents the damage to the sphincter.

Treatment of fistula on timely manner is very important to avoid the future complications. People have mis-conception that after surgery also the recovery and healing period last for years and years but this is not true. The healing & recovery period is relatively shorter via FiLac surgery. Dr. Ashwin Porwal is the 1st Fistula Surgeon in India to introduce the Filac surgery for the treatment of the fistula in Pune. Dr. Ashwin Porwal is also known as a fistula specialist & Colo rectal surgeon. He is the founder of Healing hands Clinic, Pune. He has performed & successfully treated more than 500 cases of FiLac in last one year which is highest in Asia Pacific.

Healing Hands Clinic in Pune is a Proctology (Piles, Constipation & Fistula) clinic along with Varicose Veins and Hernia treatment. Healing Hands Clinic is an ISO certified, ESCP recognized and a member of ECTA clinic in Pune. HHC is awarded as a centre of Excellence for Hernia treatment by Dr. John Murphy (Ex- President of American Hernia Society)

Mulvyadh Doctor in Pune

‘Piles’ otherwise popularly known as ‘Mulvyadh’ are the swollen blood vessels in and around the anal region. “Healing Hands Clinic” has been curing thousands of Mulvyadh patients over the years. We follow a unique approach to treat piles. The multifaceted, holistic line of treatment at HHC constitutes of MCDPA ( Medication, Constac, Diet, Physiotherapy and Ayurvedic Therapy ). If nothings work out to be effective for a patient, then a surgical intervention is suggested.

Dr. Ashwin Porwal, the best Colorectal Surgeon across India and the Founder of HHC, recommends minimally invasive and fast-curing surgical techniques instead of conventional open surgery. He introduces the latest technology Stapler Surgery a novel Mulvyadh treatment.

A Brief about Stapler Surgery..

Performed under anesthesia
No cuts and incisions from outside; the surgery is performed through anus with the help of a use-and-throw transparent device – No cuts & Incision required
Time taken for surgery – 30 minutes
Hospitalization – 24 hours
Recovery time – one week or less
Dr. Porwal has an extensive experience of curing Mulvyadh patients by Stapler surgery and our patients consider him as the best Mulvyadh doctor in Pune. He offers expert consultation and performs specialized surgeries to cure piles and constipation. We have been successfully curing thousands of Mulvyadh patients since years, who strongly recommend HHC for piles and other anorectal disease treatments. Our team has appreciatively dubbed their stories in “40000 stories of piles to smiles”.

A Novel Combination of Fistulectomy & Leonardo Laser Therapy to Cure Complex Recto-inguinal Fistula

This is a story of a long (4-5 years) suffering from fistula, of a 31 years old male patient. It started with fever and severe abdominal pain. While working at the Central Industrial Security Force (CSIF), he had a very stressful schedule with a lot of traveling all through work hours. Being a workaholic by heart, health took a back seat in his life.

The pain & fever were neglected with mere medications for a few weeks, which later aggravated in a few years and led to internal pus formation in the abdomen. Initially, the patient had no complaints such as swelling at the rectum. However, due to consistent sitting in one place & pus accumulation, he gradually started facing discomfort, bleeding stools and extreme pain. At this time, he consulted a local surgeon for immediate attention & cure. He was advised to do an Ultrasonography of abdomen & pelvis that showed pus collection in the right side of the abdomen. Later, he underwent a surgery for the same.

For a few weeks, he was totally relieved from the problem but after two months, the same symptoms began to re-occur. He got operated thrice for the drainage of pus, since the problem was seen to be recurrent every time.

Until then, the symptoms related to the rectum persisted. He was very frustrated, as his daily routine was getting hampered a lot. Later again, he was detected with pus collection in the abdomen; this time in the left side. He was frustrated enough with the ailment by the time and decided to seek a second opinion from a popular and expert surgeon in the city.

A surgeon advised him to undergo an MRI Fistulogram, which showed a big fistulous tract from the left inguinal region to the rectum (medically known as recto-inguinal fistula). He was operated for the draining pus and was addressed with a colostomy bag. This was certainly, the final hope for the patient but to his surprise, the problem re-occurred again! Stool was diverted from the abdomen. At this point, his condition was near to worst. It was like bearing the pain to live with the colostomy bag.

He was further referred to Fistula Specialist Dr. Ashwin Porwal, a renowned Colorectal Surgeon & Founder of Healing Hands Clinic and HOD of Proctology Clinic at Apollo Jehangir Hospital, which is a specialty centre for all anorectal ailments. He was further diagnosed of Complex Recto-inguinal Fistula. The findings showed that he had a fistula track that was formed from the left inguinal region (left lateral wall of pelvis) to the rectum. One opening was at the left lateral wall of pelvis and another at 6 o’clock of anus.

As the fistula had a long pathway (25 cm), Fistulectomy wasn’t possible. Thus, from the inguinal region, 7-8 cm fistulous tract was taken out and partial closure of the tract was performed. Again a 3-4 cm fistulous tract from the anal region was extracted (fistulectomy) and a total closure was performed with the help of the latest device Leonardo Laser, introduced recently by Dr. Ashwin Porwal for the first time in India. A very small opening was intentionally left open from the inguinal region & resultant wound was not completely closed, to let it heal on its own.

This patient was hospitalized for 3 days, was on IV Antibiotics. Post discharge he was advised a follow up of once in 2 weeks, for 2 months. A course of antibiotics & anti-inflammatory & antacid medications was prescribed for a month. Commenting on the aftercare follow up of the patient, he’s absolutely stable performing his normal routine at home. He has taken leave from work to recover completely.

Re-Current Pilonidal Sinus through Leo-Nardo Laser

This is a story of a 23year old female patient suffering from Pilonidal sinus. The patient was suffering from ailment sinus 2year. It started with formation of boil along with pus discharge and pain over sacral region. Being a student she had a very stressful schedule, so she started ignoring it.

As the symptoms aggravated, the patient approached a surgeon in Nanded where she was advised a fistulogram; thereby underwent a vy surgery for Pilonidal sinus. After the surgery, the patient was completely relieved from the symptoms, but after 1 year the same complaints started occurring. The patient developed a boil over the sacral region with occasional pus discharge. Pain and other symptoms were neglected by medication. However, the ailment was creating a hindrance in daily routine of the patient. This frustrated the patient a lot and forced her to go for a second opinion.

She came to know about HHC through just dial and came for consultation. She was examined by Dr.Ashwin Porwal, Colorectal Surgeon & Founder of HHC, where she was diagnosed of having pilonidal sinus on clinical examination. As it was a re-current pilonidal sinus, she was advised laser-excision of the sinus. The surgery was performed in afternoon with the help of latest device Leo-Nardo laser introduced recently by Dr. Ashwin Porwal for the first time in India. The resultant wound was left open to undergo natural healing. The patient was discharged in the evening. Post discharge, she was advised follow-up once a day in a week for 2 months so as to clean the wound and to ensure natural healing process. A course of antibiotics, analgesics and antacids is prescribed for 14 days. Commenting on the aftercare follow-up of the patient she is absolutely stable performing her normal routine.

Case Study 1 Case Study 2

Severe Anal Spasm Cured without Surgery

This is a story of an 18 years old female patient. She had a complaint of pain and burning during bowel movements since 2-3 months. Initially till two months, she neglected this symptom but later, the pain during bowel movements started to increase day-by-day. Being too young to share such kind of problems with her family members or friend circle, she was wondering how to get rid of this condition. One day, while reading newspaper, she came to know about Healing Hands Clinic, Pune. She immediately planned to visit the clinic for curing the extreme pain while bowel movements.

Dr. Ashwin Porwal (Consultant Procto Surgeon) & the founder of Healing Hands Clinic, Pune diagnosed the patient to have Severe Anal Spasm along with skin tag. The patient was afraid of undergoing a painful surgery; thus, Dr. Porwal advised her to follow the MCDPA (Medication, Constac, Diet, Physiotherapy, Ayurvedic Therapy) course, an innovative line of treatment implemented only at Healing hands Clinic. This course included medication for one month, a diet session alonmg with physiotherapy and six alternate sessions of Ayurvedic oil therapy. Constac is an advanced, herbal and non- habit forming stool softener. It not only relieves the problem of hard stools but also effectively relieves one from gas, acidity and other digestive ailments.

As soon as the patient underwent the first oil therapy session, she had relief from about 70%-75% of previous pain and she decided to continue the therapy. After completing our MCDPA course for one complete month, the patient is now totally free from pain and no hard stools complaints as well.

Piles and Anal Fissure: Awareness Is a Must!

Are you feeling pain in lower rectum and near the anus since a few days? If you see blood on your stool in addition to this pain, you might be suffering from haemorrhoids (piles) or an anal fissure. Although the symptoms may seem similar, there’s a difference between the two. While anal fissure is a tiny tear in the anus causing the formation of a linear ulcer at the boundary of the anus, piles involves swollen blood vessels near the anus, forming a protrusion to the outside.

Piles and fissure are those conditions wherein patients may have complaint of itching and bleeding. They have to suffer from a lot of pain, secretions and inability to sit down comfortably. Such lifestyle diseases affecting the anorectal health of individuals are usually intolerable. However, people take a lot of time before they finally open up before specialists about the intensity of the problem. Often traditional remedies are tried to relieve such conditions. If not diagnosed and treated in time, the ailments such as piles, fissures, and fistula may pose serious threat in the long run. Thus, it’s important to get such conditions diagnosed and initiate the possible treatments as soon as possible.

Here’s the basic information about anal fissures and piles to help you be aware of their causes, symptoms, diagnosis, treatment alternatives and preventive measures.

Common Causes
• Constipation
• Diarrhoea
• Wrong toilet habits
• Poor diet habits
• Physical inactivity
• Obesity
• Pregnancy
• Regular lifting of heavy loads
• Family history

Diagnostic Measures
• Symptomatic examination
• Rectal examination with the help of a gloved finger

Treatment Alternatives
Many people are nervous about traditional open surgery for curing a disease condition. However, surgery is not the only possible treatment for anorectal ailments. Dr. Ashwin Porwal’s Healing Hands Clinic follows a holistic line of treatment involving medication, herbal laxatives, diet & lifestyle modification, physiotherapy and Ayurveda. If none of these alternatives cures the disease effectively, surgery is the ultimate recommendation.

• For piles, HHC provides latest technology, least invasive Stapler Surgery, Laser Surgery and Laser Haemorrhoidoplasty
• For anal fissures, we offer an innovative Ayurvedic Therapy involving 5 – 6 Oil Therapy of short period of time (10 minutes for 5-7 days)

Preventive Awareness Regarding Piles and Anal Fissure
• Include whole grain breads, bran, lots of vegetables and fibrous foods in daily diet
• Snack often on fresh fruits and fruit juices
• Exercise regularly
• Avoid smoking and drinking alcohol

For more information on piles & fissure and other lifestyle diseases treatment, visit This Page. Healing Hands Clinic is a renowned piles hospital for highest quality piles, constipation, fistula, hernia, and fissure treatment.