Скачать или смотреть FISSURE Symptoms and CURE | Why Am I Passing Blood in Stool? - Dr.Nagaraj Puttaswamy|Doctors' Circle

Registration No. 39478 Karnataka Medical Council, 1994
Dr. Nagaraj B Puttaswamy | Phone 📞 : 9900061061, 08049294929 (Online & in-person appointment can be booked online or by call) | Consultant Laparoscopic and Bariatric Surgeon | PUNYA Hospitals India Pvt Ltd, Basaveshwaranagara, Bengaluru, India
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Patients come to a surgical OPD commonly or very frequently with problems related to haemorrhoids, fistula or fissure. What are these conditions, or even sometimes pilonidal sinuses? These are common problems which any patient can go through. If there is a bout of constipation and the patient has to push hard stools, there may be small cracks on the anal orifice. These are called fissures. Unfortunately, these are very, very painful and may be presented alongside a small amount of trickling of blood while the patient passes stools. This is commonly seen even right from a small child to an adult, and it is easily managed medically. A simple fissure can easily be managed medically with the help of a local ointment, and maybe we can supplement laxatives for those individuals, and sometimes a painkiller will be suggested. If this becomes a repeated activity, the patient gets into a state where it is called a chronic fissure with anorectal sphincteric spasm. So recurrently, this problem continues to happen, the patient has constipation and difficulties. The patient will not be relieved of the medical condition or medical treatment. So we subject the patient to a simple procedure called large dilation or anal dilatation along with sphincterotomy, which can be done with the help of a laser, a very simple outpatient procedure or maybe a daycare procedure. Next would be haemorrhoids. Haemorrhoids are generally called piles in common man's terms. Haemorrhoids are normal cushions of veins which are normally present. They are dilated, and they become more fragile because of the high pressure in the venous channels. They may rupture and bleed. Most of the time, hemorrhoidal bleeding is painless. So when compared to what a fissure would cause, it would be a painful, small quantity of bleeding, whereas haemorrhoids would be a painless bleed. It will be copious. A significant amount of blood may be lost. Many times it is seen in patients who have portal hypertension, maybe related to alcohol or any other related intra-abdominal pressure being high. Those patients will develop haemorrhoids easily. Those patients will present with a significant amount of bleeding while passing stool. Many patients will come with a significantly high status of anaemic status, meaning low haemoglobin status. I have seen patients collapsing in the toilet after a bout of a huge amount of blood loss. So this is again a surgical procedure. If the patient comes very early in grades one or two, we can easily treat them with medications. But if the patient has landed up in grade three or grade four surgical haemorrhoids, sometimes thrombosed haemorrhoids or gangrenous haemorrhoids can also happen. These are surgical procedures which we have to perform on those individuals. What I usually practice is a stapler hemorrhoidectomy, which is very, very convenient. Again, a daycare procedure, a weekend procedure if it is performed. Generally, what everybody understands is that any procedure related to haemorrhoids is very, very painful. Following surgery, patients would say the doctor has shown them hell on earth, but definitely related to stapler hemorrhoidectomy, I can confidently say it has changed hell to heaven. A daycare activity or one day's activity, we do a stapler procedure, and the patient can recover and maybe go back to work on the second or third day. That is a huge advantage when compared to any other conventional hemorrhoidectomy or even whether it is Doppler-assisted, cryo, or harmonic scalpel-assisted hemorrhoidectomy. Most of the time, they become conventional types, but stapler scores very high over all these types of surgical procedures.

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