Say Goodbye to Piles!

Modern treatments for piles, also known as hemorrhoids, and getting piles relief include:

• Infrared coagulation (IRC): A quick and painless procedure that uses infrared light to shrink hemorrhoids by limiting blood supply. A probe is applied to the base of the hemorrhoid to coagulate tissue and evaporate water in the cell. 
• Laser hemorrhoidectomy procedure (LHP): A laser is used to stop the blood flow to the hemorrhoids. 
• Sclerotherapy: A chemical agent is injected to create fibrosis, which fixes the mucosa to the underlying muscle. 
• Rubber band ligation (RBL): A rubber band is used to ligate the hemorrhoidal tissue, which causes scarring and ischemic necrosis. 
• Cryotherapy: A freezing cryoprobe is used to ablate the hemorrhoidal tissue. 
• High-fiber diet: A diet with more than 25 grams of fiber per day can help resolve hemorrhoidal symptoms. Fiber supplements like psyllium seed (Metamucil) and methylcellulose (Citrucel) can also help. 
• Dietary adjustments: Eating more fiber and drinking plenty of oral fluids can help keep stools regular and reduce pain and irritability. 

Modern treatments for anal fissures include:

• Laser surgery: A laser is used to vaporize the pathological tissue of the fissure. This is a modern technique that doesn't require hospitalization. 
• Lateral internal sphincterotomy (LIS): A small cut is made in the muscle surrounding the sphincter to reduce tension in the anal canal. This is a short, straightforward operation that's usually performed under general anesthetic. 
• Anal advancement flap (AAF): Healthy tissue is transferred onto the base of the fissure to improve wound healing. 
• IncoBoNT/A injection: A less invasive treatment that can be considered before surgery. 
• Botulinum toxin (Botox) injection: A toxin is injected to cause paralysis of the sphincter. 
• Oral Nifedipine: An L-type calcium channel antagonist that can be used to treat anal fissures. 
• Local application of vasodilators: Nitric oxide can help relax the internal anal sphincter. 

Other treatments for anal fissures include: Increasing fiber and water intake, Stool softeners, Antidiarrheals, Topical anesthetics, and Warm tub baths.

Modern treatments for fistulas include:

• FistulotomyThe most common surgery for anal fistulas, this procedure involves cutting the fistula open to allow it to heal as a flat scar. The surgeon may also scrape and flush out infected tissue, and flatten and stitch the tunnel. 
• Video-Assisted Anal Fistula Treatment (VAAFT)A small endoscope is inserted through the fistula's external opening to explore the tract and identify any abscesses. The tract is then obliterated using diathermy and debrided with a brush. The internal opening is closed with sutures. 
• Laser closureA laser probe is used to destroy the fistula epithelium and obliterate the fistula tract. 
• Fibrin glueThis technique stimulates the growth of fibroblasts and endothelial cells. 
• Seton placementA small piece of plastic or rubber is inserted under the skin to help drain fluids. 
• AntibioticsAntibiotics like ciprofloxacin, metronidazole, or amoxicillin-clavulic acid can be effective in combination with other agents to improve fistula closure. 

There is no simple technique that can completely heal complex anal fistulas.The healing outcome and protection of anal function should be considered when choosing a treatment. 

Modern treatments for pilonidal sinus include:

• Endoscopic ablationA less invasive procedure that uses an endoscope to clean the sinus, remove infected tissue and hair, and seal the sinus with heat. It's performed in a hospital under local or spinal anesthetic, and patients can usually leave the same day. 
• Sinus laser therapy (SiLaT)A minimally invasive procedure that uses a diode laser to treat the sinus. A small incision is made, the sinus is cleaned, and the laser is used to seal the sinus. Patients can usually be discharged within 24 hours and return to work after about five days. 
• Bascom “pit-picking and lateral drainage”A procedure that involves debriding the cavity to the midline pits, excising the pits, and primarily closing them. The lateral incision is left open for drainage. 
• AntibioticsAn ointment containing clindamycin can help relieve pilonidal sinus.