Q What is the latest in the
understanding of disease process of Piles?
the latest research has changed the way we look at piles. Earlier piles was
thought to a dilated bunch of veins but now it has become clear that the basic
defect in piles along with dilatation of veins is mucosal prolapse [ i.e. the
inner covering layer(mucosa) of rectum becomes loose and that’s why it
protrudes out]. This understanding of the disease process has led to the
improved treatment. Earlier all treatment of piles i.e. Banding, Cryotherapy, Injection
treatment, Trans rectal Doppler haemorrhoidal ligation (THD)and conventional
surgery removed or treated bunch of dilated veins(piles) without addressing the
basic cause i.e mucosal prolapse. Stapler haemorrhoidectomy is the only
treatment modality available today which by removing 1-2 cm of mucosal cuff
corrects the underlying basic pathology while giving painless relief to problem
of piles at the same time.