Patient guide
Piles are incredibly common, and there is truly no need to feel awkward talking to me about them. Most people settle down well with simple advice alone, and for the few who need more, I also offer laser and stapler options.
This page is general information from Dr. Jose John Maliakal, not a diagnosis. Your treatment plan is decided together at consultation.
What people usually notice
- Bleeding when you pass stool, usually bright red
- A soft lump near your back passage that may come out and go back in on its own
- Itching, irritation, or a damp feeling around the anus
- It's uncomfortable or painful, especially when you sit down or right after a bowel movement
- A feeling that you haven't fully emptied your bowels
- A little mucus discharge or minor staining on your underwear
When I would want you seen sooner
- If you're bleeding heavily or it won't stop, or you feel dizzy or weak along with it, please get seen straight away
- Severe pain that just won't ease, with a hard, tender lump that won't go back in, needs prompt attention
- Fever, or redness and swelling that seem to be spreading, should not wait. Come in urgently
- A sudden, large, very painful swelling needs to be checked without delay
With any of these, go to the nearest emergency department. Don’t wait for an OPD slot.
Your options
Laser proctology for piles
often day careLaser hemorrhoidoplasty (LHP)
I pass a fine laser fibre inside the affected tissue through a tiny opening, so there's no open surgical cut. This is generally the right fit for early-stage and moderate-stage piles.
PPH stapled hemorrhoidectomy
often day careProcedure for Prolapse and Hemorrhoids
Here I use a circular stapling device to reposition the prolapsing tissue and reduce its blood supply. I consider this for more advanced or prolapsing piles, where laser alone would not be the right fit.
Conventional (open) surgery
For advanced or complicated piles where laser and stapling are not suitable, straightforward surgical removal is still a dependable option, usually with a short hospital stay. I'll talk you through what's right for you.
After the procedure
Everyone is a little different, and I will confirm your own plan when I see you. Broadly, this is what to expect.
Day of the procedure
Most laser and stapled procedures are done as day care or with just a short stay. I'll confirm which applies to you at your consultation. Before you go home, I'll walk you through pain relief, diet, and wound care.
First week
Some discomfort when you pass stool is common in the first week, and medication plus warm sitz baths usually keep it manageable. Most people are up and moving, doing basic activities, within a few days.
2 to 4 weeks
Most people are back to their normal routine and work within this window. It does vary a bit, depending on the procedure and how physically demanding your job is.
Follow-up
At your follow-up visit, I'll check how you're healing and sort out any bleeding, discharge, or discomfort that hasn't settled yet.
Good to know
Do I definitely need surgery for piles?
No, not always. Many early piles settle down with diet changes, fibre, plenty of fluids, and medication. I consider surgery or laser treatment when symptoms persist, keep bleeding, or the piles prolapse, and I only make that call after examining you properly, not just from what you describe.
Does laser treatment for piles hurt?
It varies from person to person, and depends on how extensive the piles are. Most people find it manageable with the pain relief I provide, and I'll talk you through exactly what to expect for your case.
How soon can I go back to work?
It depends on the procedure and what your work involves. Many people are back at a desk job within a week to ten days, and I'll give you a timeline that suits your situation.
Will piles come back after treatment?
They can, especially if constipation or straining continues. Looking after your diet, fibre, and bowel habits afterward helps lower the chances, though I can't promise they'll never come back.
I'm bleeding down there. Is it definitely piles?
Not necessarily. Bleeding can have several causes, so it's important to get it examined rather than assumed, especially if it's new for you or you're over 40. This page is general information, not a diagnosis. I would need to examine you in person to tell you what's really going on.
Is this an embarrassing thing to bring up?
Not at all. It's one of the most common conditions I see in general surgery, day in and day out. Every consultation is handled discreetly and respectfully, so please don't feel awkward bringing it up with me.
Let us have a chat
If you are worried about a symptom, thinking about treatment, or you just want a clearer answer, send me a WhatsApp message and we will help you arrange a time at Thangam Hospital.
Thangam Hospital of PMRC
West Yakkara, Palakkad, Kerala 678004
OPD 9:00 AM – 4:00 PM
Please confirm the day’s OPD on WhatsApp before travelling.
After you message, we will confirm the day's OPD, help you pick a time, and tell you what to bring: any earlier reports and scans, your current medicines, and your insurance card if you have one. Please avoid sending sensitive medical reports on WhatsApp unless we ask you to.