Ano-rectal problems are not minor: Prof RP Sahi

[Listen to audio-recording/ podcast of Prof (Dr) RP Sahi's inaugural address here]
"Ano-rectal problems were considered as minor medical or surgical procedure and never got its due importance. Any damage done to this area by any surgical technique is very difficult to reconstruct. So one has to be a very efficient surgeon to help these patients out from the so-called minor problems - these ano-rectal problems are not minor rather very major ones" said Professor (Dr) RP Sahi, one of the senior-most and decorated surgeons of the country while inaugurating the region's first Ano-Rectal Problems Revisited Workshop at SIPS Super-Speciality Hospital in Chowk, Lucknow.

"Some of the ano-rectal problems are very painful. Better treatment and care of ano-rectal problems is possible now with new tools and technologies and if these are rationally employed, patient is back home in much shorter duration of time" said Dr Sahi.

Reminding the need to get back to basics of healthcare, Dr Sahi said: "What does a doctor usually do when a patient comes with a complaint of blood coming out of tail end? Usually a doctor prescribes an ointment for piles and patient is asked to come back again. At times these patients feel better for a while till they again notice blood while passing stools. Another ointment is likely to be prescribed. By the fourth visit, the patient is likely to become weak, anaemic, and a number of other symptoms get added. This usually happens because most qualified doctors are somehow not prepared to put a finger inside the rectum before prescribing the ointment for piles. And disasters are seen in the surgical world when patients present with inoperable ano-rectal malignancies, and other severe diseases. This could be totally avoided if every doctor is given this fundamental message to examine the patient optimally by putting the finger up the anal canal before prescribing the ointment for piles. In a simple case of haemorrhoids doctors will not feel anything unusual but if they feel anything unusual or extra, they must refer the patient to a surgical centre timely. This will save lot of life, morbidity and agony due to ano-rectal problems."

Professor (Dr) RP Sahi is the former Head of the Surgery Department at India's prestigious King George's Medical College (KGMC).

"This meet also featured a unique non-surgical technique for the management of Piles like Doppler-guided haemorrhoidal artery ligation (DGHAL) and Recto-Anal Repair (RAR). The beauty of this procedure lies in the fact that the patient is discharged within a few hours and is back to work, the very next day" said Professor (Dr) Rama Kant, Executive Director of Piles To Smiles Clinics, who is also a former Head of the Surgery Department at CSM Medical University (erstwhile KGMC) and national President-elect, Association of Surgeons of India (ASI) 2012.

Other faculty members of the workshop included  Dr Venky Munikrishnan, Director of Chennai Colo-Rectal Clinic, Dr Yogesh Mishra, Professor PK Sharma, Dr Arshad Ahmad from CSMMU and Professor Ashok Kumar from SGPGI.

Apart from scientific sessions, there were operative workshops, video demonstrations and hands-on training on ano-rectal surgery.

Piles are swellings that develop from the tissues that line the anal canal or back passage. The tissue of the anal canal is rich in blood vessels. If these vessels become dilated and swollen, they may project into the anal canal or out of the back passage (known as a prolapse) to form visible swellings.

Piles tend to be caused by factors that cause the blood vessels to swell, including anything that increases pressure inside the abdomen such as constipation, pregnancy or being overweight. Prevalence of piles is higher in pregnant women than in non-pregnant women of the same age group.

Bobby Ramakant - CNS 

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