Piles & Fistula Treatment in Surat

Piles (haemorrhoids), anal fissures, and fistulas are among the most common conditions in general surgical practice — and among the most under-reported, because patients often delay seeking help out of embarrassment or discomfort discussing symptoms in this area. Dr. Piyush Khanna treats these conditions routinely and discreetly for patients from across Surat, including Athwa, City Light, Adajan, Vesu, and Piplod. Consultation is available in Gujarati and Hindi.

If embarrassment is keeping you from calling, consider the numbers. A 2025 meta-analysis in Annals of Medicine, pooling 150 studies covering nearly 9 million people worldwide, found haemorrhoidal disease in about 26% of adults at any given time, with lifetime prevalence around 27% — and slightly higher rates in women. Piles are one of the most common conditions in medicine; discretion is sensible, delay is not.

Recognising the conditions

Piles (haemorrhoids) most typically cause painless bright-red bleeding during bowel movements, a soft lump at or near the anus, or a sensation of incomplete emptying. Larger piles can prolapse — protrude outside the anal canal — and may need to be pushed back in after opening the bowels. Anal fissure is a small tear in the lining of the anal canal, characteristically producing sharp, tearing pain during and for some time after a bowel movement, sometimes accompanied by a streak of blood. Anal fistula typically follows an anal abscess and presents as a persistent discharge, recurring painful swelling near the anus, or a small external opening that has not healed — sometimes going through cycles of partial improvement and flare-up.

Conservative treatment first

Many cases of piles and fissures respond well without surgery. Increasing dietary fibre, drinking enough water through the day, avoiding prolonged straining or sitting, and using topical or oral medication as needed resolve most early-grade piles (Grade 1–2) and the majority of acute fissures. Office-based banding for Grade 2–3 piles can be performed without general anaesthesia and avoids a surgical admission in suitable cases. Dr. Khanna assesses each patient individually and recommends the simplest effective treatment, not the most invasive one.

Surgical options for piles — including laser and stapler

When piles persistently bleed, prolapse, or fail to settle with non-surgical measures, surgical treatment resolves the problem effectively. The main options are:

• Conventional haemorrhoidectomy — surgical removal of the haemorrhoidal tissue; well-established and thorough, though post-operative discomfort is the main consideration with this approach.
• Stapled haemorrhoidopexy (PPH — Procedure for Prolapse and Haemorrhoids) — a circular stapler repositions and reduces prolapsing haemorrhoids from inside the anal canal rather than cutting externally, generally associated with less post-operative pain than conventional surgery and a quicker return to normal activity for suitable Grade 3 haemorrhoids.

The right technique depends on the grade, size, pattern, and anatomy of your haemorrhoids — Dr. Khanna advises on which option is most appropriate at consultation.

Fissure treatment

Most anal fissures (acute fissures) heal with stool-softening diet and topical treatment. A chronic fissure — present for several weeks and with fibrous edges — may not heal conservatively and typically responds to a minor, brief procedure that relaxes the muscle spasm perpetuating the tear. Recovery is measured in days for straightforward cases.

Fistula treatment

Unlike piles and fissures, fistulas almost always require surgical treatment — the abnormal tract will not close on its own and tends to cause recurring abscess and discharge if left untreated. The surgical approach depends critically on where the fistula tract runs in relation to the sphincter muscles:

• Simple, low-lying fistulas (not involving significant sphincter muscle) are typically treated by fistulotomy — laying the tract open — which is reliable and definitive.
• Complex fistulas involving the sphincter are handled with sphincter-sparing techniques, most commonly a seton (a thread gradually cutting through tissue over weeks), to balance curing the fistula with protecting continence.

Getting fistula surgery right — treating the problem while protecting the muscles that control bowel control — is one of the more technically demanding aspects of general surgical practice, and one where Dr. Khanna's continuous experience since 1991 is directly relevant to the outcome.

Preventing recurrence

Consistent everyday habits reduce the chance of piles and fissures returning after treatment: adequate dietary fibre, enough water, not straining at stool, and managing constipation promptly. These habits do not replace surgical treatment when it is genuinely needed, but they make a real difference to long-term outcome and quality of life.

Related reading: laparoscopic surgery overview, hernia treatment, gallbladder surgery, revision & complex GI surgery, or view all conditions treated. Questions? See patient FAQ or contact & directions. Deeper reading: piles, fissure and fistula — what works and why.