Will Piles reoccur after Surgery or other treatments

Concept behind recurrence of Hemorrhoids disease even after treatment or surgery

Article by: Dr. Naveen Chauhan, Consultant Ayurveda Proctologist, Ghaziabad

In my 14 years of Ano-rectal clinical practice probably the most common query raised by the patients regarding the treatment of Hemorrhoids is ‘Is Surgery or kshar sutra is the permanent solution for piles/hemorrhoids disease’? The honest answer to this question is both Yes and No. Let me explain you how it is so?

In my previous posts I have already explained that pathological Piles or Hemorrhoids are swollen veins in the anal canal that sometimes bleed or prolapsed out due to prolonged straining and constipation etc. Piles are graded according to the symptom i.e. 1st grade or 1st degree, 2nd Degree, 3rd Degree and 4th degree. Hemorrhoids of larger sizes i.e. of 3rd and 4th degree require surgery or kshar sutra procedure for treating them. Both procedures involves excision of piles masses from their bases by different techniques performed under suitable anesthesia. Now in general three Piles masses which corresponds to three venous plexus are at 3, 7 and 11’o clock position as observed in Lithotomy or Knee abdomen position. These are called as primary piles or Primary Hemorrhoids. Piles mass present at any other position except 3, 7 or 11’o clock positions is termed as Secondary piles or Secondary hemorrhoids.

During the course of treatment once these primary piles are removed by kshar sutra ligation procedure or by surgery there are very rare chances of recurrence at the same o’clock positions. As the root cause of Piles disease is constipation and Mandagni (according to Ayurveda). Weak digestion or Mandagni leads to slow movement of food through the digestive system which eventually leads to constipation. Due to constipation patient keeps on straining which can lead to formation of secondary piles masses after a few years which may present the similar symptoms like Bleeding, prolapsed of mass etc. The symptoms of primary piles or secondary piles are the same and it is impossible to distinguish between primary or secondary piles unless patient is examined by a physician or proctologist. 

So, formation of pathological hemorrhoids after surgery or kshar sutra treatment is possible though it is rare and time taking. And patient will call it recurrence as he is unaware of the concept of primary and secondary piles/hemorrhoids.

So, avoiding constipation by diet management is the best prevention for Piles disease’s recurrence.

I feel the concept of recurrence of Piles disease is more clear in your mind after going through this article.

About Dr. Naveen Chauhan

**Author is a qualified Ayurveda Surgeon and is practicing Kshara sutra treatment since past 14 years. The above article is for patient education and not a substitute for a medical advice. Dr. Chauhan can be contacted through email nchauhan.dr@gmail.com or by phone +91-9818069989