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Pancreatitis Conditions We Treat

Haemorrhoids (Piles)

Overview

Haemorrhoids, commonly called piles, are swollen and inflamed veins in the rectum or anus that can cause pain, bleeding, and discomfort. They may develop due to chronic constipation, prolonged straining, pregnancy, obesity, or sitting for long hours. While mild cases can often be managed with lifestyle adjustments, advanced haemorrhoids may require surgical treatment for lasting relief.

Symptoms

The symptoms of haemorrhoids vary depending on whether they are internal or external, and they may range from mild irritation to severe pain. Common signs include:

  • Bleeding during bowel movements – often bright red blood seen on toilet paper or in the stool.
  • Pain or discomfort – especially when sitting, walking, or passing stools.
  • Itching or burning sensation around the anal area due to irritation.
  • Swelling or lump near the anus – caused by thrombosed external haemorrhoids.
  • Mucus discharge or rectal prolapse in severe, untreated cases.

Diagnosis

Timely diagnosis helps determine the severity of haemorrhoids and guides the best treatment approach. Our evaluation may include:

  • Physical examination of the anal area to check for external haemorrhoids or prolapse.
  • Digital rectal exam to assess internal haemorrhoids and rule out other causes of bleeding.
  • Proctoscopy or anoscopy for a detailed view of the rectal canal and internal haemorrhoids.

Treatment 

Treatment for haemorrhoids depends on the stage and severity of symptoms. We focus on both immediate relief and preventing recurrence:

  • Lifestyle and dietary modifications – a high-fibre diet, adequate fluids, and stool softeners help ease bowel movements and reduce strain.
  • Topical medications and sitz baths – provide symptomatic relief from pain and irritation.
  • Laser Surgery for piles – a precise, minimally invasive option with faster recovery and less pain.
  • Stapler haemorrhoidopexy or haemorrhoidectomy – for advanced or recurrent cases where other treatments are ineffective.
  • Long-term prevention – includes lifestyle counseling, weight management, and bowel habit training to avoid recurrence.

Anal Fissures

Overview

An anal fissure is a small tear or cut in the lining of the anus, often caused by passing hard stools, chronic constipation, or straining during bowel movements. It can also result from prolonged diarrhoea, childbirth, or inflammatory bowel disease. Though small in size, fissures can cause severe pain and bleeding, making daily activities very uncomfortable if left untreated.

Symptoms

Anal fissures are usually easy to recognise because of the sharp, cutting pain they cause. Common symptoms include:

  • Severe pain during and after bowel movements – often described as a sharp, burning, or tearing sensation.
  • Bleeding – small amounts of bright red blood on toilet paper or in the stool.
  • Itching or irritation – due to inflammation around the anus.
  • Visible tear or crack – sometimes noticed during a physical exam.
  • Spasm of the anal sphincter – which can worsen pain and delay healing.

Diagnosis

Diagnosis of anal fissures is usually straightforward and requires minimal testing:

  • Physical examination – the doctor gently inspects the anal region to identify the tear.
  • Exclusion of other conditions – such as hemorrhoids, infections, or anal fistulas, which can mimic fissure symptoms.

Treatment 

Treatment focuses on relieving pain, promoting healing, and preventing recurrence:

  • Dietary and lifestyle changes – high-fibre diet, hydration, and stool softeners to reduce strain.
  • Topical ointments – such as pain-relieving creams or medications that relax the anal sphincter and improve blood flow.
  • Warm sitz baths – to soothe pain and relax the sphincter muscles.
  • Laser Surgery for fissures – a minimally invasive and precise option for chronic or non-healing fissures, with faster recovery.
  • Long-term care – includes bowel habit training, dietary planning, and avoiding constipation to prevent recurrence.

Anal Fistulas

Overview

An anal fistula is an abnormal tunnel that forms between the anal canal and the skin near the anus. It often develops after an untreated anal abscess, when the infection creates a passageway that fails to heal properly. Fistulas can cause persistent discharge, pain, and recurrent infections if not treated.

Symptoms

Anal fistulas may vary in severity, but common symptoms include:

  • Pain and swelling around the anus – especially during bowel movements.
  • Recurrent discharge – pus or blood-stained fluid from an opening near the anus.
  • Recurrent abscesses – repeated swelling and infection that keeps coming back.
  • Skin irritation – itching, soreness, or discomfort due to constant leakage.
  • Fever or malaise (in some cases) – if the infection spreads or worsens.

Diagnosis

Accurate diagnosis helps determine the fistula’s location, complexity, and the best treatment option:

  • Physical examination – checking for external openings or tenderness.
  • Digital rectal exam – to identify internal openings or tracks.
  • Imaging tests – such as MRI or endoanal ultrasound, which provide detailed mapping of fistula tracts.
  • Proctoscopy – sometimes used to confirm the exact position of internal openings.

Treatment 

Since anal fistulas rarely heal on their own, treatment usually involves surgical intervention:

  • Antibiotics & drainage – for initial infection control.
  • Fistulectomy – removal of the fistula tract for permanent cure.
  • VAAFT (Video-Assisted Anal Fistula Treatment) – a minimally invasive, advanced approach that uses a scope to visualise and seal the tract with precision.
  • Seton placement – sometimes used in complex fistulas to keep the tract open and allow controlled healing.
  • Laser treatment – offers a quicker, less invasive option for certain cases.
  • Post-treatment care – includes hygiene measures, pain management, and follow-up to prevent recurrence.

Pilonidal Sinus

Overview

A pilonidal sinus is a small tunnel or cyst that forms in the skin near the tailbone, just above the buttocks crease. It usually develops when hair and debris become trapped under the skin, leading to infection and abscess formation. This condition is more common in young adults, especially those who sit for long periods.

Symptoms

Pilonidal sinus symptoms can range from mild discomfort to painful infections:

  • Pain or swelling near the tailbone – especially while sitting or bending.
  • Redness and tenderness – skin around the sinus may feel sore to touch.
  • Discharge – pus, blood, or foul-smelling fluid may leak from the sinus opening.
  • Recurrent abscesses – repeated flare-ups and painful swelling.
  • Fever (in severe cases) – if the infection spreads or worsens.

Diagnosis

Diagnosis is straightforward and usually involves a physical examination:

  • Clinical evaluation – identifying the sinus opening, swelling, or discharge.
  • Assessment of abscesses – checking for infection, abscess formation, or multiple tracts.
  • Imaging (in complex cases) – MRI or ultrasound may be used to evaluate the extent of deeper tracts.

Treatment 

Treatment focuses on removing the sinus tract, preventing infection, and reducing recurrence:

  • Incision and drainage – for painful abscesses to provide immediate relief.
  • Surgical excision – removal of the sinus tract and infected tissue.
  • Laser or minimally invasive techniques – to clear the sinus with less pain and quicker recovery.
  • Flap surgery – for complex or recurrent cases, where skin is repositioned to cover the area and reduce recurrence risk.
  • Post-operative care – includes wound hygiene, hair removal, and lifestyle advice to prevent recurrence.

Perianal Abscess

Overview

A perianal abscess is a painful collection of pus that develops near the anus due to infection of small anal glands. It often starts suddenly and can cause severe discomfort. If not treated promptly, it may progress to an anal fistula.

Symptoms

Common signs and symptoms include:

  • Severe pain around the anus – throbbing pain that worsens with sitting, coughing, or bowel movements.
  • Swelling and redness – tender lump or swelling near the anal area.
  • Discharge – pus or bloody fluid may drain from the abscess.
  • Fever and chills – a sign that the infection is spreading.
  • Difficulty sitting or walking – due to intense discomfort.

Diagnosis

Early diagnosis is key to preventing complications:

  • Physical examination – to detect swelling, redness, and tenderness around the anus.
  • Rectal examination – to assess deeper abscesses.
  • Imaging (ultrasound or MRI) – sometimes used to detect hidden or complex abscesses.

Treatment 

The mainstay of treatment is drainage, supported by infection control:

  • Incision and drainage (I&D) – the standard treatment to release pus and relieve pressure.
  • Antibiotics – used in certain cases, especially if the infection is widespread or in immunocompromised patients.
  • Post-care management – includes warm sitz baths, pain relief, and proper wound hygiene.

Constipation

Overview

Constipation is a common digestive concern that affects people of all ages. It occurs when bowel movements become infrequent, hard, or difficult to pass, often causing discomfort and strain. While occasional constipation is usually temporary, chronic constipation can interfere with daily life, lead to complications such as haemorrhoids or anal fissures, and may indicate underlying digestive or metabolic issues. Causes include a low-fibre diet, inadequate fluid intake, sedentary lifestyle, certain medications, hormonal changes, and gastrointestinal disorders. Proper evaluation and treatment can restore bowel regularity and improve overall digestive health.

Symptoms

Constipation can present in varying degrees of severity. Common symptoms include:

  • Infrequent bowel movements – Fewer than three times per week, sometimes accompanied by long intervals without stool.
  • Hard, dry, or lumpy stools – Often difficult or painful to pass, increasing the risk of straining.
  • Straining or prolonged effort during defecation – Can cause discomfort, anal pain, or complications like haemorrhoids.
  • Feeling of incomplete evacuation – A persistent sensation that the bowel has not fully emptied.
  • Abdominal bloating, cramps, or discomfort – A result of stool accumulation and slowed intestinal transit.
  • Nausea or loss of appetite – Occasionally accompanies severe constipation, especially when bowel movements are obstructed.

Diagnosis

A thorough evaluation helps determine the underlying cause and guides appropriate treatment:

  • Medical history review – Includes assessment of bowel habits, diet, fluid intake, medications, and lifestyle.
  • Physical examination – Abdominal and rectal exams help identify obstruction, stool impaction, or structural issues.
  • Laboratory tests – Blood tests to rule out metabolic or hormonal disorders contributing to constipation.
  • Imaging and specialized tests – Colonoscopy, or motility studies may be recommended for chronic or severe cases to detect obstructions, anatomical anomalies, or motility disorders.

Treatment 

Treatment focuses on relieving symptoms, addressing underlying causes, and preventing recurrence:

  • Lifestyle and dietary adjustments – Incorporating a high-fibre diet (fruits, vegetables, whole grains), maintaining adequate hydration, regular physical activity, and establishing consistent bowel routines.
  • Medications – Laxatives, stool softeners, osmotic agents, or prokinetic drugs may be used short-term under medical supervision.
  • Pelvic floor therapy and biofeedback – Beneficial for patients with pelvic floor dysfunction or difficulty passing stools.
  • Addressing underlying conditions – Correcting metabolic disorders, adjusting medications, or treating gastrointestinal diseases contributing to chronic constipation.
  • Long-term prevention – Education on healthy bowel habits, fibre intake, hydration, and lifestyle adjustments to maintain regularity and prevent recurrence.

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Gastroenterology FAQs

When should I see a Gastroenterologist?

You should visit a Gastroenterologist if you have persistent digestive issues like heartburn, bloating, constipation, diarrhoea, or unexplained abdominal pain.

Acid reflux is often triggered by spicy foods, caffeine, alcohol, smoking, obesity, and late-night eating. Lifestyle changes and medication can help manage symptoms.

Symptoms include jaundice (yellowing of skin/eyes), fatigue, swelling in the legs, dark urine, and persistent nausea. Liver disease can be caused by infections, alcohol, or fatty liver.

A Colonoscopy is a screening test for colon cancer and digestive disorders. It’s recommended if you’re over 45 or experiencing blood in stool, unexplained weight loss, or chronic diarrhea.

Fiber-rich foods like fruits, vegetables, whole grains, and yogurt promote gut health, while processed foods, dairy, and fried foods may worsen digestive issues.

Common symptoms include severe pain after eating fatty foods, nausea, vomiting, and bloating. Gallbladder issues like gallstones may require dietary changes or medical treatment.

A Hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
In many cases, it causes no or very few symptoms, although you may notice a swelling or lump in your tummy (abdomen) or groin.
The lump can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear.

Cancer Screening is looking for cancer before a person has any symptoms. This can help find Cancer at an early stage. When abnormal tissue or Cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

The following types of tests are used to screen for Colorectal Cancer:

  • Fecal occult blood test
  • Sigmoidoscopy
  • Colonoscopy
  • CT Colonography
  • CEA assay
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