ANORECTAL CONDITION · CONDITION GUIDE

Piles / Haemorrhoids

Q: At what stage do haemorrhoids need surgery?

Grade III haemorrhoids that prolapse on straining and require manual reduction, and Grade IV haemorrhoids that are permanently prolapsed, generally require surgical treatment. Grade I and II haemorrhoids can usually be managed with dietary modification and office-based procedures such as banding or sclerotherapy.

Q: Is laser haemorrhoid treatment better than conventional surgery?

Laser treatment offers significantly less post-operative pain and faster return to normal activities compared to conventional haemorrhoidectomy. It is suitable for Grades II–III. Conventional haemorrhoidectomy remains the gold standard for large Grade IV haemorrhoids and carries the lowest recurrence rate.

Q: How long is recovery after haemorrhoid surgery?

Recovery depends on the procedure. Banding and sclerotherapy are day-case procedures with minimal downtime. Laser treatment and PPH allow return to work within a few days. Conventional haemorrhoidectomy involves 1–2 weeks of discomfort with full recovery in 3–4 weeks.

Swollen vascular cushions in the anal canal causing bleeding, prolapse, and discomfort — treated with minimally invasive procedures or surgical haemorrhoidectomy based on severity.

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Painless Laser Piles Surgery by Dr. Tagore

Very Common PREVALENCE

20–45 Min PROCEDURE DURATION

Day Case HOSPITAL STAY

ABOUT THIS CONDITION

What is Piles / Haemorrhoids?

Haemorrhoids (piles) are enlarged and symptomatic vascular cushions in the anal canal. They are classified as internal (above the dentate line), external (below), or mixed. Grade I and II internal haemorrhoids typically respond to dietary modification and office-based procedures. Grade III and IV haemorrhoids causing significant prolapse, bleeding, or discomfort require surgical treatment. Dr. Tagore Mohan Grandhi offers a comprehensive range of haemorrhoid treatments at Lux Hospitals, Hyderabad, from rubber band ligation and sclerotherapy for early-grade disease to laser haemorrhoidoplasty, stapled haemorrhoidopexy, and conventional haemorrhoidectomy for advanced grades. The treatment is selected based on haemorrhoid grade, symptoms, and patient preference.

SIGNS TO WATCH

Common Symptoms

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Symptoms that need attention

Bright red rectal bleeding during or after defaecation Prolapse of tissue through the anus on straining Anal itch, discomfort, or soiling of underwear Mucous discharge and perianal skin irritation Pain, particularly with thrombosed external haemorrhoids Sensation of incomplete evacuation after defaecation

WHY IT HAPPENS

Causes & Risk Factors

Chronic straining during defaecation due to constipation
Low-fibre diet leading to hard stools and prolonged straining
Prolonged sitting on the toilet
Pregnancy and increased intra-abdominal pressure
Chronic diarrhoea causing repeated anal engorgement
Genetic predisposition to weak connective tissue support

CLINICAL DETAILS

KeyFacts

Grading

Grade I–IV; treatment selected by grade and symptoms

First-line

Dietary change, laxatives, and local treatments for Grades I–II

Procedures

Banding, laser, stapled PPH, MIPH, conventional excision

Recovery

Day case for most procedures; 1–2 weeks pain after excision

Recurrence

Lifestyle modification reduces long-term recurrence

Hospital

Available at Lux Hospitals, Hitech City, Hyderabad

HOW WE TREAT IT

Treatment Approach

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Laser Haemorrhoid Treatment

Laser haemorrhoidoplasty (LHP) uses laser energy to ablate haemorrhoidal tissue with minimal damage to surrounding structures. Dr. Grandhi offers this procedure as a minimally invasive, virtually painless alternative to conventional haemorrhoidectomy, with rapid recovery and return to normal activity within days.

Available at Lux Hospitals, Hitech City, Hyderabad

1

Clinical Assessment & Grading

Proctoscopy confirms the diagnosis and grades haemorrhoidal disease. Flexible sigmoidoscopy or colonoscopy excludes other causes of rectal bleeding in patients with risk factors.
2

Conservative Measures & Office Procedures

Grade I and II haemorrhoids are managed with dietary fibre, adequate hydration, and rubber band ligation or injection sclerotherapy as an outpatient procedure.
3

Surgical Treatment for Advanced Grades

Grade III and IV haemorrhoids are treated with laser haemorrhoidoplasty, stapled haemorrhoidopexy (PPH/MIPH), or conventional haemorrhoidectomy under spinal or general anaesthesia.
4

Post-procedure Care

Adequate analgesia, stool softeners, and sitz baths are recommended post-operatively. A high-fibre diet is maintained long-term. Most patients return to work within 1–2 weeks.

AVAILABLE TREATMENTS

TreatmentOptions

Rubber Band Ligation

Elastic bands placed at the base of internal haemorrhoids, cutting off blood supply. Effective outpatient treatment for Grades I–III.

Injection Sclerotherapy

Injection of sclerosant solution into the haemorrhoidal tissue causing fibrosis and shrinkage. Used for Grades I–II.

Laser Haemorrhoid Treatment

Laser ablation of haemorrhoidal tissue with minimal post-operative pain, rapid recovery, and day-case convenience.

MIPH (Minimally Invasive Procedure for Haemorrhoids)

Stapling technique that excises the prolapsing haemorrhoidal mucosa and repositions internal haemorrhoids to their normal anatomical position.

Stapled Haemorrhoidopexy (PPH)

Circular stapler removes a ring of redundant rectal mucosa, repositioning prolapsed haemorrhoids. Reduced post-operative pain compared to conventional excision.

Conventional Haemorrhoidectomy

Surgical excision of haemorrhoidal tissue under anaesthesia. Gold standard for Grade III–IV haemorrhoids with the lowest long-term recurrence rate.

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COMMON QUESTIONS

Frequently Asked Questions

At what stage do haemorrhoids need surgery?+

Is laser haemorrhoid treatment better than conventional surgery?+

How long is recovery after haemorrhoid surgery?+

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