Q: I had prolapsed piles during my 1st pregnancy. After delivery I had a stapler surgery. Everything was fine. After 2 and half years I had my 2nd baby and during delivery I again had the same problem. What do you suggest? Is surgery the only option or do you suggest any other method? I am using proctoglyvenol cream and suppository twice a day; will it affect breast feeding or have any adverse effect on my baby’s health? He is 3 weeks old.

A:Stapler surgery has a recurrence rate of 4-5%; after open surgery the recurrence rate is 1-2%. Have the piles just recurred or have they prolapsed again? Prolapsed piles would be very unusual after surgery! I suggest: wait for six months, if you can. Then look at the options. If possible, avoid re-operation. If the piles are prolapsing, you may not be able to wait too long. Are you sure they are prolapsing piles, not a rectal prolapse? Get checked for this. The local cream will not harm your baby. I don't know if the cream will help you, actually.