Q: I am suffering from piles since last 2 years and I am taking homeopathy but if I stop taking these, the problem starts within 2-3 days. How long do I have to take this? I am also having fissures. Do I need surgery? Should I go for laser surgery?

A:Piles and fissures are different. Piles are dilated, swollen veins in the anal canal. Sometimes they swell so much that they pop out, and bleed. If your doctor says you have grade three or grade four piles, you need surgery (haemorrhoidectomy). If you have smaller piles (grades one or two) they need injection or banding treatment. If you have grade one or two piles that have continued to bleed despite banding or injection, you need surgery. Surgery can be open or stapler. Don’t think about laser. Stapler surgery causes less pain than does open surgery. Recurrence after good open surgery is 1-2%, after good stapler surgery are about 4-5%. However, I recommend stapler since the discomfort is less, and if I needed haemorrhoidectomy I would (having done both types of operation extensively) choose staplers any time. Fissures are small injuries on the anal region, and are quite painful. Early fissures need medicines and hot water baths. Advanced fissures need surgery: this surgery is very minor. If you have both piles and fissure, usually you would need to be treated for the piles: this will anyway cure the fissure. However, consult your doctor.