What is this?
Person suffering from piles usually will not have pain or burning sensation in the anus. Some soft mass or tissue comes out of the anus. It may go inside after the defecation. Sometimes have to push inside the anus after defecation. In chronic cases it lies or hangs outside the anus, which will not go inside at all. Another complaint in piles is bleeding. Hemorrhoids are painless (it may be painful if blood clotted inside the piles or if it is associated with other diseases like fissure-in-ano etc.)

Why and what happens here?
Cause for this is-passing hard stool, straining in the toilet for long time for passing stool and hereditary factors. Other than this consumption of more spicy, fried foodstuff, junk food etc leads to incomplete formation of stool. This type of food does not give bulkiness to the stool. So that one has to strain in the toilet for passing the stool also passing stool 3-4 times a day.

Because of repeated straining loosely placed veins or blood vessels in the anus start bulging or engorged. These vessels takes ball like shape comes out of the anus during defecation. As it is made up of blood vessels it starts bleeding.

What you have to do?
One should pass soft stool. Take raw, green leafy vegetables, which have high fiber content. Take 8-10 dry grapes soaked in water at bedtime. Avoid straining while defecation. If you are a high B.P. patient, check blood pressure and control immediately. Avoid oily, fried, non-vegetarian, curry foodstuffs. If it is associated with pain this may be due to blood clotting the piles. For this, sit in warm water for ten minutes in a wide mouthed tub. Take one glass of warm milk at bedtime. Take warm water in the morning soon as you get up. You have to consult the doctor for confirmation of the diagnosis and further management.

What an Ayurveda surgeon does?
This cannot be cured only by oral medications in some stages. However, immediate intervention also not required in all the cases of the piles, if it is not bleeding.

Sushruta, father of surgery wrote a book on surgical procedures in 500 B.C. in his treaties he mentioned about a disease and line of management. He broadly categorized to bheshaja (medicine), kshara Alkali application),agni (cauterization), shastra (surgical excision).This is a contribution by him in the management of piles to the Indian system of medicine.One among these treatment modalities is kshara karma. Ayurveda surgeons practice this procedure in hospital set-up. Dr.RaviShankar Pervaje, practicing Ayurveda surgeon, very well standardized this. Therefore this procedure properly known as ‘Pervaje technique’ of ksharakarma.

An alkaline paste prepared out of plants with other ingredients is called kshara. In the operation theatre under local /general/spinal anesthesia kshara to be applied to the piles. After one minute it should be washed with sour liquids. Within a minute of time it turns in to black color. This pile mass gets thromboses and necroses over a period of 8 days. Patient may have little pain after the procedure. This can be managed by analgesics. Have to stay in the hospital for maximum one day.  Same day one can take normal food after coming out of anesthesia.

How this is advantageous?
This also good boon for piles patients because –no cutting of the tissues (for internal piles), less pain, minimal invasive technique, less cost, less recurrence, less hospitalization.