Q: My father-in-law is suffering from epilepsy. Few months back he got piles and now the doctor wants him to undergo surgery. Is it possible for an epileptic person to undergo operation for piles? How is the operation done? Will he have to stop the tablets, which he takes for epilepsy daily?

A:Piles are swollen veins at the anal canal. They may bleed, and can be treated by injection of a sclerosant or by surgery. Most surgery today is by using a stapler. Epilepsy has nothing to do with piles, and patients with epilepsy may undergo surgery. The risk is during anesthesia. Some medicines used for epilepsy affect the metabolism of anesthetic agents. This is not a problem for a trained anesthesiologist. Some epileptics develop serious convulsions (a condition known as status epilepticus) after anesthesia. This may be a genuine problem. The risk is small, but serious. Should your father-in-law undergo surgery? If an experienced surgeon has said that surgery is essential, then the answer is yes, provided that the surgery is done by him in a well-equiped hospital, by a senior anesthesiologist, with due inputs from a qualified neurologist.