Dilated plexus of superior hemorrhoidal veins in relation to anal canal is called as hemorrhoids / Piles.
Bleeding per rectum during defecation and protrusion of mass at anal orifice replaced digitally or itself after defecation. Other symptoms of piles are mucous and blood discharge, itching at perianal region with Habitual Constipation. During defecation Flash pan will be seen most cases of Piles.
Grade i – Piles which Bleed.
Grade ii – Piles partly prolapsed as the straining increases during defecation.
Grade iii – After prolapsed can be digitally replaced the Piles.
Grade iv – Piles permanently prolapsed outside the anus.
Constipation causes excessive straining with superior hemorrhoidal veins pass through the sub-mucosa of the rectum, get constricted during the act of defecation. Low fiber diet, Pregnancy, Persistent straining when passing of stool and urine, anal intercourse, and hereditary factors also causes of Piles.
Initial three treatments are Modern surgery, Rest 4 are conducting in my centre according to requirement of Situation.
Complications After Surgery
Recurrences, Anal Stricture & Post operative severe bleeding are the main Complications of Piles after Modern surgery.
Fistula in Ano
An inflamatory track which has an external opening in the perianal skin and an internal opening in the anal canal or rectum. This track is lined by unhealthy granulation tissue and fibrous tissue. This can be start by a boil or abscess from perianal area, after burst continious pus / liquid discharge from that area.
Persistent purulent discharge keeps the under cloth part always wet. External opening can be single / Multiple, discharge of pus / blood with pain may be present or abscent. Internal opening in carcinoma felt as a ‘buttonhole’ defect inside rectum.
Anal gland infection with formation of boils or abscesses at perennial region which bursts with discharge of pus / blood. Patients with pulmonary TB have got 1-2 % chances of developing fistula in ano with watery discharge without pus. Recurrent fistula may be associated with Diabetes mellitus, Chronic Ulcerative colitis, and Prostate infection.
3. Fistulectomy with / without colostomy.
4. Ksharasutra Application(Ayurvedic Method )
5. Pratisaraniya Kshara Application (Ayurvedic Method.)
6. Partial Fistulectomy with Pratisaraniya Kshara Application.
Initial three treatments are Modern surgery, Rest 3 are conducting in my centre according to requirement of Situation.
Complication After Surgery
Incontinence is the major problem in High anal fistula. So there is no control on bowel evacuation. Recurrence rate is more than 50 – 60 %. In multiple horse shoe fistula excision of the rectum and colostomy is the only choice of operation for complete eradication of disease.
Fissure in Ano
Longitudinal tear in the lower end of anal canal results in Fissure in Ano.It occurs most commonly in the midline posteriorly, the least protected part of the Anal canal.
Pathology of Pain
Fissure starts proximally at the dentate line. So,whole of the anal fissure lies in the sensitive skin of the anal canal and that’s why Pain is the most prominent symptoms.
There is a sharp cutting burning or tearing pain in Posterior (6 o’clock) / Anterior (12 o’clock) part of anal canal which persists for some hours after defecation is over. Severe constipation is the primary problem. Stool is hard, pellet like and there is a drop of blood or streak of fresh blood during defecation. Sentinel pile refers to tag of skin at the outer end of the fissure.
Constipation & Spasm of internal sphincter is the main cause.
2. Lateral Sphincterectomy
3. Posterior Sphincterectomy
4. Lord’s Anal dilatation
5. Lord’s Anal dilatation with Ksharasutra Application on sentinel pile mass (Ayurvedic Method )
Initial three are Modern surgery rest 2 are conducting in my centre according to requirement of Situation.
Complication After Surgery
The operative results of anal fissure are not always satisfactory. Various types of complications like rectal incontinence, fecal soiling of underwear and recurrences are common complications after operations for anal fissure. Majority of the patients are dissatisfied with these types of modern operations.
Prolapse of Rectum
Protrusion of mucous membrane or the entire rectum outside the anal verge is called as Prolapse of the rectum.Commonly seen in children & elderly patients.
Excessive mucus discharge causing irritation to the perianal skin. During examination upon straining the rectum descends downwards. Bleeding and protrusion of mass during defecation replaced itself or digitally is the common complaints of patient.
It can follow an attack of diarrhoea resulting in loss of fat in the ischiorectal fossa, which supports the rectum. In infants due to undeveloped sacral curve and in children it can be secondary to habitual constipation.
1. Stapler treatment
2. Surgical excission after anal dilatation
3. Digital reposition after lubricating with lignocaine jelly
4. Pratisaraniya Kshara Application (Ayurvedic Method)
5. Vasti of Musika Taila for more than 3 months. (Ayurvedic Method)
Initial two treatments are Modern surgery, last two are conducting in my centre according to requirement of Situation.
Intermittent boil with discharge of pus, hairs and blood occurs on sacral region in mid spinal line between natal cleft. In acute phase natal abscess is formed which is associated with pain and fever. Some time hairs are collecting from the sinus. The abscess is burst with discharge and symptoms are relieved leaving the intermittent or persistent discharging sinus.
External opening of the sinus seen just above the anal verge in the midline over the coccyx. History of recurrent abscess is which rupture and discharge Pus.
Continuous sitting in vehicles as driver. Hairy males are suffering more. Hair accumulates due to vibration and friction causing shedding of the hair. Thus it accumulates in the gluteal cleft and enters the opening of the sweat glands.
1.Excision of Sinus track by Open method & closed method after injecting methylene blue.
2.Ksharasutra Application (Ayurvedic method )
It is a mass or swelling arising from mucosal lining of bowel wall. It may be pedunculated or sessile. The polyp consists of rounded head and long pedicle which is attached to the mucosal surface. It may occur anywhere in the large intestine but the commonest site of polyp is rectosigmoidal region of intestine. Juvenile Polyp is most common in children below age 12 years.
Below the age of 12 year mostly seen as complain like bleeding and protrusion of mass per rectum. During digital exam it is unable to expel outside, only during defecation come outside. Sometimes no external mass is there only bleeding per rectum is the main complain during and after defecation.
1.Excision of mass under GA.
2.Ligation of Ksharasutra immediate after defecation under sedation.(Ayurvedic Method)
Initial one is Modern surgery whose recurrence rate is 15-20 % and Second one is conducting in my centre. Still now since 10 years I have not seen any recurrence in patient.
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