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Chronic FISSURES have returned with PILES after surgery.

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Hi, I'm suffering from chronic fissures and grade 1 piles, I had an operation before two years old patientago and it now has returned to become worst then ever.
My proctologist has put me on laxatives and some in house medicine but no relief.
I have changed my diet completely which excludes all whites, heavy protein and includes lots of fruits , vegetables, fruits and fish occasionally due to which I now get Bristol type 5-6 faeces. This doesn't let me control the urge and I have to go immediately to the job, this leads to heavy pressure exerted automatically. I have also noticed that there is some kind of obstruction which doesn't allow the bowel to pass easily and it causes fissures in that area due to the existing pressure. I in fact take time to ease the pressure by manually loosen it or by applying extra lubricant.
So I want to know what is it that is causing this again and again despite of having regular bowel movement and not having constipation.

My doc is suggesting to undergo laser treatment for piles but doesn't guarantee its recurrence.
Please help as I suffer with this everyday and it is messing up with my day to day activities which is leading to frustration. I am now planning to get operated again but I'm very much sceptical about its recurrence.

Category: General Surgeon

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Category: Pediatric Surgeon
 30 Doctors Online

Thank you for your query at

As per your description, you are having Fissure in ano and Grade I piles.
The anatomy of Rectum and Anal canal is designed to control the faeces.
In my opinion, for Fissure in ano, you should go for Lateral sphincterectomy. The results are excellent.
For Grade 1 piles,you better continue the same diet pattern. There is no need for any surgical treatment. If the piles change to Grade 2 or 3,you can think of Laser surgery.
I am sorry to say that no one will give guarantee about recurrence.
If you take high fiber diet, drink plenty of liquids, eat fresh fruits and vegetables, chances of recurrence is low.
Nothing to worry.
Hope I answered your query. If you have any questions, I will clarify further.
Wish you good health.

Dr. Hari Charan Perigela
Category: Pediatric Surgeon
Fellowship: DNB, General Surgery, National Board of Examinations, New Delhi, 2001
Residency: MS, General Surgery, Sri Venkateswara Medical College,Tirupathi, 2000
Medical School: MBBS, Kurnool Medical college, 1995
Dr. Hari Charan Perigela and 4 other Medical Specialists are ready to help you

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