Bleeding through anus is the warning sign .You must consult at the earliest to Surgeon/proctologist/colorectal surgeon in your locality. He will confirm the diagnosis of Piles or other rare causes like It can be very very rarely be due to carcinoma of rectum or other inflammatory bowel disease.. Also he will rule out associated fissure or fistula.

No. If piles are detected at early stage it can be treated by dietary life style modifications

1)Grade I -At early stage piles can be treated by dietary changes life style modifications.
2) Grade II piles can be treated by rubber banding of piles or injecting the drug in the piles mass called sclerotherapy. Both procedure are done as OPD procedure at the time of consultation, You don’t require pain killer in fact you can resume on work immediately after sclerotherapy of piles or after banding the piles
3)Grade III piles you have the option of traditional surgery for piles
Known Milligan-Morgan hemorrhoidectomy (Gold standard surgery for piles.)
4)Laser surgery for piles`
5) Stapler surgery for piles.
6) Doppler-guided hemorrhoidal artery ligation with rectal mucopexy  technique
7) Grade IV Piles: It is treated with standard surgery for piles or by LASER surgery for piles or Stapler surgery for piles or Doppler-guided hemorrhoidal artery ligation with rectal mucopexy technique

LASER rays are very precisely controlled by doctor .Hence ablation of piles is precise without damaging the surrounding area of piles.

• Most skillful & trustworthy surgeon with more than 35 years of experience.
• Dedicated staff
• Patient safety assured (NABH ACCEDITATION)
• Tailor made treatment for each patient,
• Amicable packages for surgery,
• Cashless friendly.

No at early stages it can be treated with medicines, However if pain is very severe OR with recurrent attacks you need surgery.

Fistula in ano is a condition when there is small opening around anal area discharging the liquid & socking the undergarments. Pain is a symptom when the discharge is stopped & small swelling occurs around the opening.

There can be high anal fistula, Low anal fistula.

There can be multiple openings of the fistula, semi horse shoe shape fistula or ,horse shoe shape fistula.

There can be secondary fistulas due to various colonic diseases or tuberculous infection.

Fistulotomy

The most common type of surgery for anal fistulas is a fistulotomy. This involves cutting along the whole length of the fistula to open it up & remove fistulous tract so that it heals as a flat scar.

A fistulotomy is the most effective treatment for many anal fistulas, although it’s usually only suitable for fistulas that do not pass through much of the sphincter muscles, as the risk of incontinence is lowest in these cases.

If the surgeon has to cut a small portion of anal sphincter muscle during the procedure, they’ll make every attempt to reduce the risk of incontinence.

In cases where the risk of incontinence is considered too high, another procedure may be recommended instead.

Seton techniques

If your fistula passes through a significant portion of anal sphincter muscle, the surgeon may initially recommend inserting a seton.

Advancement flap procedure

An advancement flap procedure may be considered if your fistula passes through the anal sphincter muscles and having a fistulotomy carries a high risk of causing incontinence.

LIFT procedure

The ligation of the intersphincteric fistula tract (LIFT) procedure is a treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky.

During the treatment, a cut is made in the skin above the fistula and the sphincter muscles are moved apart. The fistula is then sealed at both ends and cut open so it lies flat.

Endoscopic ablation

In this procedure, an endoscope is put in the fistula.

An electrode is then passed through the endoscope and used to get rid off the fistula.

Endoscopic ablation works well and there are no serious concerns about its safety.

Laser surgery

Radially emitting laser fibre treatment involves using a small laser beam to seal the fistula.

Fibrin glue

Treatment with fibrin glue is currently the only non-surgical option for anal fistulas.

It involves the surgeon injecting a glue into the fistula while you’re under a general anaesthetic. The glue helps seal the fistula and encourages it to heal.

It’s generally less effective than fistulotomy for simple fistulas and the results may not be long-lasting, but it may be a useful option for fistulas that pass through the anal sphincter muscles because they do not need to be cut.

Bio prosthetic plug

Another option is the insertion of a bio prosthetic plug.

This is a cone-shaped plug made from animal tissue that’s used to block the internal opening of the fistula.

This procedure works well for blocking an anal fistula and there are no serious concerns about its safety.