All you wanted to know about Piles / Hemorrhoids surgery

Dr. Manish Joshi is a Consultant Surgical Gastroenterologist, GI Oncologist and Advanced Laparoscopic Surgeon at the Trustwell Hospitals, Bangalore. He aslo consults at Apollo Spectra – Koramangala & Apollo Clinic – Kundalahalli Gate . He had earlier served as Head of Surgical Gastroenterology services at St. John’s Medical College Hospital & BGS Gleneagles Global Hospital, Bangalore. Dr.Manish Joshi is an expert for Piles / Hemorrhoids surgery in Bangalore.

What is Haemorrhoids?

Haemorrhoids (piles) are small, blood-filled cushions located just inside the anal canal (internal haemorrhoids) but can sometimes form outside the anus (external haemorrhoids).

What is Piles / Haemorrhoids?

Haemorrhoids (piles) are small, blood-filled cushions located just inside the anal canal (internal haemorrhoids) but can sometimes form outside the anus (external haemorrhoids).This is a very common disease affecting people across the world.

Piles / Hemorrhoid Grades

There are 4 grades of haemorrhoids

Grade 1– only bleeding, No prolapse
Grade 2– The pile mass prolapses temporarily during defecation but goes back into the anal canal on its own. Presents with bleeding and mucous discharge
Grade 3-The pile mass prolapses during defecation but needs manual reduction. Presents with bleeding and mucous discharge
Grade4– The pile mass remains prolapsed & does not go inside the anal canal. Presents with pain and bleeding.

Signs and Symptoms

1.Bleeding from the anal canal. Hemorrhoidal bleeding typically results in bright red blood either on the toilet paper or actually into the commode after bowel movements, generally painless in nature.
2. Anal discomfort or itchiness
3. Mucus discharge
4. Prolapse with a lump coming through the anus
5.Rarely, blood clots inside a haemorrhoid and causes a painful hard lump on the outside of the anus called thrombosed external haemorrhoid. It causes severe pain along with prolapse.

Piles / Hemorrhoids surgery in Bangalore

Risk Factors

Risk factors for developing haemorrhoids include

Straining at stool


Low fibre diet



The main ways to avoid having problems with haemorrhoids are to eat a high fibre diet and avoid straining at stools.


Your doctor will examine your anal canal and rectum in the left lateral position with the knees drawn up toward the chest as high as possible. This position allows your doctor to clearly inspect the perianal skin and perform digital rectal examination and Proctoscopy. A Proctoscopic examination is essential to clearly inspect the hemorrhoidal tissue and anal canal. After this initial examination, depending on the age of the patient and other clinical condition, the decision regarding the need for more proximal colorectal evaluation like sigmoidoscopy / colonoscopy will be considered.

Piles / Hemorrhoids Surgery Treatment Options

Treatment of Haemorrhoids depends on the grade of Haemorrhoids. For Grade 1 Haemorrhoids, dietary modification with fibre supplementation & medical treatment with local ointments works in 90% of cases.
Open Haemorrhoidectomy

Open Haemorrhoidectomy

A hemorrhoidectomy is used for Grade 3 & 4 type of hemorrhoids and are not responding to nonsurgical management. 

During the surgery, Dr.Manish Joshi & team will cut out the haemorrhoids. This procedure takes place under anesthesia. When the operation is over, you’ll be taken to a recovery room for a brief period of observation. Once the doctors are  sure that your vital signs are stable, you’ll be able to return home.

Laser Hemorrhoidoplasty

With help of a optic fibre, laser energy is delivered into the Haemorrhoidal mass for a brief period. This laser energy causes the pile mass to shrink. The procedure is relatively painless and takes less time compared to the open procedure. Most patients can be discharged on the same day.
Laser treatment of Piles / Hemorrhoids
Piles / Hemorrhoid Surgery - Stapled Hemorrhoidopexy

Stapled Haemorrhoidopexy

In Stapled Haemorrhoidectomy, we excise a circumferential portion of the anal canal mucosa and submucosa and reanastomose it using a circular stapling device. As a result, the prolapsed anal cushions are retracted into their normal anatomic positions within the anal canal and the blood flow into the cushions is decreased. As it is performed above the dentate line, the pain associated with excisional open hemorrhoidectomy is avoided.

Rubber band Ligation

It is an OPD procedure used in treatment of grade 2 haemorrhoids where rubber bands are deployed using a special instrument cutting off the blood supply to the haemorrhoid and thus reducing the bleeding.

Piles / Hemorrhoid Surgery

What preparation is required before Piles / Hemorrhoids surgery?

  1. Preoperative preparation includes blood check up, medical evaluation, and anaesthesia check up etc.
  2. Surgeon will ensure risk free surgery by providing you with all the information about the operation.
  3. Please bring all your medications with you.
  4. Please tell us if you have any allergies or if you are allergic to any medications or dressings. Please tell the ward staff about all of the medicines you use.
  5. It is highly recommended not to eat or drink anything after midnight or the night before the operation. You can take prescribed medication from surgeon with a sip of water.
  6. Drugs such as aspirin, blood thinners, may need to be stopped temporarily 3-7 days before the procedure. It may be started as per your doctors advice

Post Operative Instructions

  • You may eat and drink normally, 4 hrs after the procedure.
  • You will be given a laxative for two weeks after the operation to prevent constipation. We also recommend a high fibre diet and fluid intake of at least six to ten glasses of water daily as you need to make sure the stools are soft and you don’t strain while defecation.
  • You will be given painkillers to take by mouth
  • You need to have sitz baths (a 15 minute bath in water as warm as you can tolerate) several times daily or as often as you require them. These are very soothing and provide several hours of pain relief

Post Operative Complication

  • Haemorrhoidectomy is generally a very safe operation with few risks, but, as with any surgical procedure, complications do occasionally occur which include
  • Pain
  • Bleeding
  • Urinary retention and insertion of urinary catheter
  • Rarely, wound infection

Piles / Hemorrhoids surgery FAQ's

Dr.Manish Joshi & team will discuss the pro & cons of each treament options and help you choose the best option depending on your conditions & grade of haemorrhoid. With Dr.Manish Joshi – You are in Trusted Hands.

The cost of Haemorrhoid surgery in Bangalore is in the range of Rs. to Rs. There are many factors which affect the pricing such as the complexity of the disease, type of rooms choosen etc. Please call us at +91-9148184166 to know more about the pricing.

Most insurance in India & abroad pay the cost of Haemorrhoid / piles surgery. However there are minor fine prints that you would need to check accordingly to your health insurance policy.We suggest to talk to your insurance provider directly or call us at +91-9148184166 and we will help you as much as we can.

As described on this website, there are some procedures where you can go back to your home the same day or at the max. the next day (if your insurance policy requires you to stay in hospital for 24 hrs). 

If you undergo open Haemorrhoidectomy , you might need to stay for a couple of days in the hospital. 

If you have undergone a OPD day care treatment option, you can go back to work the next day itself. If you have undergone open haemorrhoidectomy, then you can go back to work after 3-4 days

You should go back to your normal life, as soon as you feel comfortable.

Haemorrhoidectomy is generally a very safe operation with few risks, but, as with any surgical procedure, complications do occasionally occur which include

  • Pain
  • Bleeding
  • Urinary infection
  • in some cases, wound infection
  • issues due to anesthesia.

Ask the Doctor

Hospital Stay

In most cases, you may need to stay in the hospital overnight for the pain control & watch for bleeding.

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Dr. Manish Joshi is the Best Gastrointestinal surgeon in Bangalore & India. He is an expert in Advanced Laparoscopic & Robotic Surgical Techniques. His motto is ‘Patient comes first” View Profile.

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