Treatment of Piles without Operation and without Pain New Horizon in Piles Treatment

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We all know by dint of modern and sohpisticated technology the developed countries of the world have achieved tremendous success in the field of medical treatment. With the help of such a modern technology now-a-days 80-90% of the piles patients are treated with the help of a modern instrument requiring no surgical intervention and getting no pain.

The instrument is first discovered by Dr. Blaisdell by which he showed how to do treatment of piles as out patient basis and without the need for operation. He drew admirable attention from all concerned. Before this, injection treatment for piles was available since 1869. The injection sclerotherapy does not give long term satisfactory success.

Injection gives good result only in first degree or preliminary stage of piles. A study in this connection shows that the people who undergo such treatment 80% of them show recurrence of piles symptoms after one year. The medical scientists have also proved that repeated injection after failure does not give better result. Rather it gives rise to some complications. Under these circumstances the invention of ring ligation system in the treatment of piles has opened up a new horizon.

Another dimention was added to the advancement made by Dr. Blaisdell when Dr. J. Baron made an improvement in the design of the instrument and in two research paper he claimed that this new approach of treatment was giving wonderful result. World renowned piles specialist of USA Dr. Marvin L Corman and Dr. DM Steinberg have done extensive clinical trial with this instrument on piles patients and concluded that 80-90% of piles patients can be successfully treated by this instrument without having the need to undergo operation.

Who are the appropriate candidates?

With few exceptions all the piles patients can be treated by this method. Exceptional patients can be categorized as follows-patients with external piles, hypertrophied anal papilla, associated anal fissure or fistula, Grade IV piles which always hang outside, thrombosis, infection, gangrene etc.

Details of the Procedure

This procedure is done on out patient basis. That is, in chamber of a surgeon. There is no need for any kind of anesthesia. We identify the piles with the help of proctoscope and then apply the instrument in proper place. The patient is not supposed to get any pain. The patient should be informed about the procedure beforehand so as to get his cooperation.

It should be mentioned here that bleeding through anus may be due to cancer of rectum or colon. It is sometimes hard to differentiate between piles and cancer by listening to the history of the patient. So it is very pertinent to do a colonoscopy before the procedure specially when the patient's age is about 40 or has family history of colonic cancer.

This procedure needs to be done about three times successively at a particular interval because we have three main piles in our body. The piles cuts off after a few days. It looks like an operation without cutting by a knife.

Advice after the procedure

No need to take any leave from your office. One can go back home on rickshwa or car comfortably. Patient is asked to rest for six hours. Bowel management should be done in such a way that the patient does not need to force to pass motion. It is better to avoid beef and mutton for a week. Vegetable and fruits are beneficial.

Complication

There may be slight discomfort after the procedure. Very few may feel slight pain which is easily treated. In very rare instances there can be some other problem which can be solved.

Comments

With the invention and application of this instrument we can now treat 80-90% of piles patient without operation and without pain. Satisfactory result is obtained with this single technique. It is internationally accepted that this technique is a reasonable alternative to operative treatment. This is very economic, it saves time, risk and money. This is less complicated and having less side effect. Because of it's long term success and availability it is easily acceptable to patients and so very commonly used and internationally popular. For last 9 years we have done reserch on 29,635 patients all having problem of rectum and anal canal. We have treated 2400 piles patients with the method called ring ligation in a span of 9 years. About 92% of patients were cured without operation So, I can confidently say now that vast majority of piles patients can be permanently cured without any operation.

Submitted By:
PROFESSOR DR. AKM FAZLUL HAQUE
MBBS, FCPS, FICS

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