Sarvodaya Colon and Anal Clinic
Sarvodaya Colon and Anal Clinic
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    • HOME
    • ABOUT US
    • SPECIALITIES
    • TREATMENTS
    • FAQ
    • GALLERY
    • CONTACT
    • SARVODAYA HOSPITAL
    • SIDDHARTHA PHUKAN'S BLOG
  • HOME
  • ABOUT US
  • SPECIALITIES
  • TREATMENTS
  • FAQ
  • GALLERY
  • CONTACT
  • SARVODAYA HOSPITAL
  • SIDDHARTHA PHUKAN'S BLOG

Hemorrhoids (Piles): Expert Diagnosis and Modern Treatment

Hemorrhoids, commonly known as piles, are one of the most frequent conditions affecting the anal canal. Although many people experience hemorrhoids at some point in their lives, they often delay seeking medical attention due to embarrassment or fear of surgery.


At Sarvodaya Anal and Colon Clinic, we provide comprehensive evaluation and individualized treatment for hemorrhoids using evidence-based, minimally invasive techniques designed to relieve symptoms while minimizing pain and recovery time.


Several factors increase pressure within the hemorrhoidal cushions, including:

  • Chronic constipation
  • Repeated straining during bowel movements
  • Prolonged sitting on the toilet
  • Pregnancy
  • Obesity
  • Low-fiber diet
  • Sedentary lifestyle
  • Chronic diarrhea
  • Increasing age
  • Family predisposition


Most patients can be diagnosed during an outpatient consultation.

Evaluation may include:

  • Detailed medical history
  • Physical examination
  • Digital rectal examination
  • Anoscopy
  • Proctoscopy
  • Colonoscopy (when indicated, particularly in patients with rectal bleeding or other concerning symptoms)


Treatment depends on symptom severity, hemorrhoid grade, and patient preferences.


Many early hemorrhoids improve with conservative management.

Recommendations include:

  • High-fiber diet
  • Adequate hydration
  • Regular exercise
  • Avoiding prolonged sitting on the toilet
  • Preventing constipation
  • Good bowel habits


Medications may provide symptom relief but generally do not eliminate enlarged hemorrhoids.

These may include:

  • Stool softeners
  • Fiber supplements
  • Topical creams or ointments
  • Anti-inflammatory medications
  • Pain relievers

Medicines are most effective for mild disease or as part of postoperative care.


Rubber band ligation is a simple outpatient procedure commonly used for Grade I and selected Grade II hemorrhoids.


MIPH (Minimally Invasive Procedure for Hemorrhoids) is an advanced technique designed primarily for prolapsing internal hemorrhoids (typically Grade III and selected Grade IV).

Instead of removing the hemorrhoids themselves, a circular stapling device removes a ring of redundant tissue higher inside the rectum. This lifts the hemorrhoidal cushions back into their normal position and reduces their blood supply.

  • Significantly less postoperative pain than conventional excisional hemorrhoidectomy
  • Short hospital stay
  • Faster return to work
  • Minimal external wounds
  • Effective treatment of prolapse

At Sarvodaya Anal and Colon Clinic, MIPH is offered after careful patient selection to ensure the best outcomes.


Laser hemorrhoid procedures use controlled laser energy to shrink the hemorrhoidal tissue while preserving surrounding structures.

Potential advantages include:

  • Less tissue trauma
  • Minimal bleeding
  • Reduced postoperative discomfort
  • Early recovery
  • Suitable for selected patients

Laser treatment is not appropriate for every type of hemorrhoid. The choice depends on the grade, anatomy, and symptoms.


Excisional hemorrhoidectomy remains the gold standard for certain advanced or complex hemorrhoids.

It may be recommended for:

  • Large external hemorrhoids
  • Combined internal and external hemorrhoids
  • Recurrent disease
  • Thrombosed hemorrhoids
  • Cases unsuitable for MIPH or laser procedures

Although recovery is generally longer than with some minimally invasive options, conventional surgery provides excellent long-term results when indicated.


Which treatment is ideal for you 

There is no single treatment that is ideal for every patient.

The most appropriate option depends on:

  • Grade of hemorrhoids
  • Presence of prolapse
  • Severity of bleeding
  • External component
  • Associated anal conditions
  • Previous treatments
  • General health and expectations

Our goal is to recommend the least invasive treatment that provides durable symptom relief.


Can haemorrhoids be prevented 

Healthy bowel habits can reduce the risk of developing or recurring hemorrhoids.

Helpful measures include:

  • Eat a fiber-rich diet.
  • Drink plenty of water.
  • Exercise regularly.
  • Avoid prolonged straining.
  • Respond promptly to the urge to pass stool.
  • Limit time spent sitting on the toilet.
  • Maintain a healthy body weight.


When should you see a doctor 

Arrange a consultation if you experience:

  • Bleeding during or after bowel movements
  • A lump or swelling around the anus
  • Persistent pain or discomfort
  • Itching that does not improve
  • Tissue protruding from the anus
  • Recurrent hemorrhoid symptoms
  • Any change in bowel habits or unexplained weight loss

Early evaluation not only provides relief but also helps exclude other conditions that can mimic hemorrhoids.


At Sarvodaya, we combine compassionate care with modern colorectal expertise. Every patient receives a thorough evaluation, a clear explanation of the diagnosis, and a personalized treatment plan. Whether conservative management is sufficient or a minimally invasive procedure such as MIPH is appropriate, our focus is on achieving durable relief, preserving function, and helping patients return to their normal lives as quickly and comfortably as possible.

Anal Fissure: Causes, Symptoms and Modern Treatment

An anal fissure is one of the most painful conditions affecting the anal canal. Even a small tear can cause intense pain that may last for several hours after passing stool. Because of this pain, many patients begin to avoid bowel movements, leading to constipation and creating a vicious cycle that prevents healing.


At Sarvodaya Anal and Colon Clinic, we specialize in the diagnosis and treatment of anal fissures using the latest evidence-based therapies. Many fissures heal without surgery, while chronic fissures can be effectively treated with minimally invasive procedures that restore comfort and quality of life.


An anal fissure is a small tear or split in the lining (mucosa) of the anal canal. It most commonly occurs in the posterior midline but may also occur in the anterior midline, particularly in women.

The tear exposes sensitive nerve endings and causes spasm of the internal anal sphincter muscle. This muscle spasm reduces blood flow to the fissure, making healing difficult and contributing to severe pain.


The most common causes include:

  • Passing hard or large stools
  • Chronic constipation
  • Repeated straining during bowel movements
  • Persistent diarrhea
  • Childbirth
  • Inflammatory bowel disease (such as Crohn's disease)
  • Previous anal trauma
  • Anal intercourse (less common)

Although anyone can develop an anal fissure, it is especially common in young and middle-aged adults.


Pain is the hallmark of an anal fissure.

Patients often describe it as:

  • Sharp, cutting, or tearing pain
  • A sensation of "passing broken glass"
  • Pain lasting from several minutes to several hours after bowel movements
  • Burning discomfort while sitting

This pain is usually much more severe than that caused by hemorrhoids.


Small amounts of bright red blood may be noticed:

  • On the toilet paper
  • On the surface of the stool
  • In the toilet bowl

Bleeding is usually mild but should always be evaluated by a specialist to exclude other causes of rectal bleeding.


Because bowel movements become extremely painful, many patients begin to postpone passing stool.

This leads to:

  • Worsening constipation
  • Harder stools
  • Larger tears
  • More pain

This cycle often prevents spontaneous healing.


CHRONIC ANAL FISSURE

  • Persists for more than 6–8 weeks
  • Edges become thickened
  • Sentinel skin tag may develop
  • Internal sphincter muscle fibers may be visible
  • Often requires procedural or surgical treatment


Diagnosis is usually based on:

  • A detailed medical history
  • Gentle examination of the anal region

In many patients, the pain is so severe that a digital rectal examination is deferred until symptoms improve.

Additional investigations such as anoscopy, proctoscopy, or colonoscopy may be recommended if there is significant bleeding, atypical features, recurrent fissures, or suspicion of another underlying condition.


The choice of treatment depends on whether the fissure is acute or chronic, its severity, and the patient's symptoms.

Most acute fissures heal without surgery.

Treatment focuses on relieving pain, reducing sphincter spasm, and promoting healing.

Patients are advised to:

  • Increase dietary fiber
  • Drink adequate water
  • Avoid constipation
  • Exercise regularly
  • Establish regular bowel habits

Soft stools reduce trauma during bowel movements and allow the fissure to heal.

Sitting in warm water for 10–15 minutes several times a day helps:

  • Relax the anal sphincter
  • Improve blood flow
  • Reduce pain
  • Promote healing

Prescription creams may help relax the internal sphincter muscle and improve healing.

These include:

  • Calcium channel blocker ointments (e.g., diltiazem or nifedipine)
  • Nitroglycerin ointment (used selectively)

These medications can heal many chronic fissures when used correctly.

Appropriate pain medication may be prescribed during the acute phase to improve comfort.


Lateral Internal Sphincterotomy (LIS) is considered the gold standard surgical treatment for chronic anal fissure that has failed conservative management.

During the procedure, a small portion of the internal anal sphincter muscle is divided to relieve spasm and restore blood flow, allowing the fissure to heal.

Benefits - 

  • Excellent healing rates
  • Rapid pain relief
  • Durable long-term results
  • Short hospital stay
  • Early return to normal activities

When performed by experienced colorectal surgeons and in appropriately selected patients, the risk of long-term bowel control problems is low.

Most patients experience significant improvement in pain within a few days after successful treatment.

Recovery recommendations include:

  • Continue a high-fiber diet
  • Drink plenty of fluids
  • Take prescribed stool softeners
  • Avoid straining during bowel movements
  • Perform warm sitz baths as advised
  • Attend follow-up appointments to monitor healing


PREVENTION 

Good bowel habits are the key to prevention.

Helpful measures include:

  • Eat a fiber-rich diet every day.
  • Drink 2–3 liters of water daily (unless medically restricted).
  • Exercise regularly.
  • Avoid delaying bowel movements.
  • Prevent constipation and prolonged straining.
  • Limit time spent sitting on the toilet.


Seek medical evaluation if you have:

  • Severe pain during or after bowel movements
  • Bright red bleeding from the anus
  • Persistent constipation associated with anal pain
  • A fissure that has not healed after several weeks of treatment
  • Recurrent fissures
  • Any persistent anal symptoms that interfere with daily life

Early treatment not only relieves pain but also prevents the development of chronic fissures that may require surgery.


At Sarvodaya Anal and Colon Clinic, we understand how debilitating an anal fissure can be. Our approach begins with a careful diagnosis and personalized treatment plan, emphasizing conservative therapy whenever appropriate. For chronic or recurrent fissures, we offer advanced options such as Botox injection and Lateral Internal Sphincterotomy, using evidence-based techniques that provide excellent healing rates while preserving normal bowel function. Our goal is simple: to relieve pain, restore comfort, and help you return to a healthy, confident life as quickly as possible.

Fistula in Ano: Expert Diagnosis and Advanced Sphincter-Preserving Treatment

An anal fistula (fistula in ano) is a chronic condition that can cause persistent pain, swelling, discharge, and recurrent abscesses around the anus. Although it is a common condition, treatment can be challenging because the fistula often passes through the muscles responsible for bowel control. The primary goal of treatment is therefore not only to cure the fistula but also to preserve continence.


At Sarvodaya Anal and Colon Clinic, we provide individualized treatment based on the anatomy of the fistula, using modern imaging, minimally invasive techniques, and sphincter-preserving procedures whenever appropriate.


An anal fistula is an abnormal tunnel that connects the inside of the anal canal to the skin around the anus.

Most fistulas develop after an anal gland becomes infected, forming an abscess. Although the abscess may drain spontaneously or be surgically drained, the tract connecting the infected gland to the skin may persist, resulting in a fistula.

Simply put:

Abscess → Persistent tract → Anal fistula


Patients may experience:

  • Persistent discharge near the anus
  • Recurrent swelling
  • Pain around the anus
  • Repeated abscess formation
  • Bleeding
  • Irritation or itching
  • A small opening near the anus that intermittently drains pus

Many patients notice cycles of swelling, spontaneous rupture with discharge, temporary relief, and recurrence.


A simple fistula usually has:

  • A single tract
  • Minimal involvement of the sphincter muscles
  • One external opening
  • No secondary branches
  • No associated inflammatory bowel disease

These fistulas generally have a high cure rate with relatively straightforward surgery.


Complex fistulas are more challenging and require careful planning.

They may have:

  • Multiple tracts
  • Horseshoe extensions
  • High involvement of the sphincter muscles
  • Multiple external openings
  • Recurrent disease
  • Association with Crohn's disease
  • Anterior fistulas in women
  • Suprasphincteric or extrasphincteric anatomy

Treating complex fistulas requires balancing complete healing with preservation of continence.


Diagnosis begins with:

  • Detailed history
  • Physical examination
  • Gentle digital rectal examination
  • Anoscopy or proctoscopy

For complex or recurrent fistulas, additional imaging is often recommended.


MRI is considered the gold standard for mapping complex fistulas because it clearly identifies:

  • Internal opening
  • Secondary tracts
  • Abscess cavities
  • Horseshoe extensions
  • Relationship to sphincter muscles

This information is invaluable for planning surgery and reducing the risk of recurrence.


TREATMENT 

The best treatment depends on:

  • Type of fistula
  • Location of the internal opening
  • Amount of sphincter muscle involved
  • Previous surgeries
  • Presence of Crohn's disease or other underlying conditions

Our aim is to eradicate the fistula while preserving normal bowel control.


Fistulotomy is the standard treatment for many simple, low anal fistulas.

During the procedure, the fistula tract is opened along its length, allowing it to heal gradually from the base.


A seton is a soft surgical thread placed through the fistula tract. Setons may be temporary or part of a staged treatment strategy.


The LIFT procedure is a widely accepted sphincter-preserving operation for selected transsphincteric fistulas.

The fistula tract is identified within the intersphincteric plane, tied off, and divided without cutting the external sphincter muscle. Benefits include - 

  • Preserves bowel control
  • Minimal muscle division
  • Good healing rates
  • Suitable for selected complex fistulas
  • Faster recovery than more extensive operations


Laser-assisted fistula treatment uses a radial laser probe to deliver controlled energy inside the fistula tract, causing it to collapse and seal.

Potential advantages include:

  • Minimal tissue trauma
  • Small wounds
  • Reduced postoperative discomfort
  • Early return to daily activities
  • Preservation of the anal sphincter

Laser treatment is not suitable for every fistula. Careful patient selection is essential for achieving good outcomes.


Recovery depends on the complexity of the fistula and the procedure performed.

Most patients are advised to:

  • Take regular warm sitz baths
  • Maintain excellent hygiene
  • Follow wound care instructions carefully
  • Eat a high-fiber diet
  • Drink plenty of water
  • Avoid constipation
  • Attend scheduled follow-up visits

Some procedures require dressing changes until healing is complete.


Can Fistula's be preventable? Not all fistulas can be prevented, but early treatment of anal abscesses and prompt medical attention for persistent discharge or swelling may reduce complications.

Maintaining good bowel habits and seeking specialist care early can also improve outcomes.


When to consult your surgeon 

You should seek medical attention if you experience:

  • Recurrent swelling near the anus
  • Persistent pus or blood-stained discharge
  • Repeated anal abscesses
  • Pain around the anus
  • An opening near the anus that continues to drain
  • A fistula that has recurred after previous surgery

Early evaluation can prevent repeated infections and improve the chances of successful treatment.


At Sarvodaya Anal and Colon Clinic, we recognize that every anal fistula is unique. Rather than applying a single technique to all patients, we use a tailored, anatomy-based approach supported by clinical examination and, when indicated, MRI mapping. Our expertise includes fistulotomy, seton placement, LIFT, laser-assisted fistula treatment, and advanced sphincter-preserving procedures, allowing us to select the safest and most effective treatment for each individual. Our commitment is to achieve complete healing while protecting the muscles that control continence, helping our patients return to normal life with confidence and comfort.

Colon and Rectal Diseases: Comprehensive Diagnosis and Advanced Surgical Care

The colon (large intestine) and rectum play vital roles in digestion, water absorption, and bowel function. Disorders affecting these organs range from benign conditions, such as polyps and diverticular disease, to chronic inflammatory diseases and colorectal cancer. Many of these conditions share common symptoms, including rectal bleeding, changes in bowel habits, abdominal pain, or unexplained weight loss.


At Sarvodaya Anal and Colon Clinic, we provide comprehensive evaluation, advanced endoscopic diagnosis, and modern medical and surgical treatment for diseases of the colon and rectum. Our goal is early diagnosis, evidence-based management, and personalized care for every patient.


You should seek medical evaluation if you experience:

  • Rectal bleeding
  • Persistent constipation or diarrhea
  • A change in bowel habits lasting more than 2–3 weeks
  • Blood mixed with stool
  • Unexplained abdominal pain
  • Unexplained weight loss
  • Iron deficiency anemia
  • Persistent bloating
  • Mucus in stool
  • A family history of colorectal cancer or colon polyps

Early evaluation can identify treatable conditions before complications develop.


Colon polyps are abnormal growths arising from the inner lining of the colon or rectum. Most polyps are benign, but some types—particularly adenomatous and certain serrated polyps—have the potential to develop into colorectal cancer over time.

Most polyps do not cause symptoms and are discovered during colonoscopy.


Diverticula are small pouch-like protrusions that develop in the wall of the colon, most commonly in the sigmoid colon. The presence of diverticula is called diverticulosis.

When these pouches become inflamed or infected, the condition is known as diverticulitis.


Colon cancer develops from the inner lining of the large intestine, often evolving slowly from precancerous polyps over several years. Early detection greatly improves the chances of successful treatment. Risk factors include - 

  • Increasing age
  • Family history
  • Colon polyps
  • Inflammatory bowel disease
  • Obesity
  • Smoking
  • Excess alcohol consumption
  • Diet high in processed or red meat
  • Physical inactivity

Warning signs 

  • Blood in stool
  • Persistent change in bowel habits
  • Unexplained weight loss
  • Fatigue
  • Iron deficiency anemia
  • Abdominal pain
  • Narrow stools
  • Intestinal obstruction

Diagnosis may involve:

  • Colonoscopy with biopsy
  • CT scan
  • MRI (when indicated)
  • Blood tests
  • Tumor markers such as CEA

Treatment is individualized based on the stage of the disease and may include:

  • Minimally invasive (laparoscopic or robotic) surgery
  • Open surgery
  • Chemotherapy
  • Targeted therapy
  • Immunotherapy (selected patients)
  • Multidisciplinary care

Surgery remains the cornerstone of treatment for most localized colon cancers.


Rectal cancer arises in the last 15 cm of the large intestine and requires specialized management because of its proximity to the anal sphincter and pelvic nerves.

Treatment planning often differs from colon cancer and may involve a combination of surgery, chemotherapy, and radiotherapy.


Inflammatory bowel disease (IBD) refers to chronic conditions that cause ongoing inflammation of the digestive tract. The two main forms are:

  • Ulcerative colitis, which affects the colon and rectum
  • Crohn's disease, which can affect any part of the digestive tract from the mouth to the anus

IBD is not the same as irritable bowel syndrome (IBS).

Management is individualized and may include:

  • Anti-inflammatory medications
  • Immunomodulators
  • Biologic therapies
  • Nutritional support
  • Surgery for complications such as strictures, fistulas, perforation, or medically refractory disease

Patients with IBD require long-term follow-up and periodic surveillance for colorectal cancer.


Colonoscopy 

Many diseases of the colon and rectum can only be diagnosed accurately through colonoscopy. This procedure allows direct visualization of the lining of the large intestine and enables:

  • Detection of inflammation
  • Identification of polyps
  • Biopsy of suspicious lesions
  • Removal of precancerous polyps
  • Diagnosis of bleeding sources
  • Surveillance after previous treatment

For many patients, colonoscopy provides both diagnosis and treatment in a single procedure.


While not all conditions can be prevented, healthy lifestyle choices can significantly reduce the risk of colorectal disease.

We recommend:

  • Eating a diet rich in fruits, vegetables, and whole grains
  • Maintaining a healthy weight
  • Exercising regularly
  • Avoiding smoking and excessive alcohol
  • Limiting processed and red meat
  • Seeking prompt evaluation for rectal bleeding or changes in bowel habits
  • Undergoing screening colonoscopy when recommended


At Sarvodaya Anal and Colon Clinic, we provide comprehensive care for both benign and malignant diseases of the colon and rectum. Our services include screening and diagnostic colonoscopy, advanced polypectomy, minimally invasive colorectal surgery, multidisciplinary cancer care, and long-term management of inflammatory bowel disease. Every patient receives an individualized treatment plan based on current international guidelines, with a focus on accurate diagnosis, organ preservation, enhanced recovery, and compassionate care. Whether you need evaluation for rectal bleeding, removal of a precancerous polyp, or treatment for colorectal cancer, our team is committed to delivering safe, modern, and patient-centered care at every stage of your journey.

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