Post Treatment Hemorrhoids Management

Hemorrhoids,  otherwise called Piles are swollen veins inside or around the anal area and rectum that cause torment and inconvenience while sitting, walking, or any other movements. Small sprouted masses of hemorrhoids may clear up within a couple of days with no treatment. However, enormous or external types of hemorrhoids can take more time to recuperate in healing and may require a hemorrhoid medical procedure to eliminate the culpable hemorrhoids.

However, there are diverse treatment modalities including surgeries accessible for treating hemorrhoids starting from Hemorrhoidectomy, laser medical procedures in allopathy to Ayurvedic approaches beginning from all-encompassing restorative healing with kshara-sutra treatment. Individuals encountering hemorrhoids who need to have a go at treating them with Ayurvedic medication ought to anticipate herbal cures, way of lifestyle changes, and perhaps negligibly intrusive measures as a feature of their treatment plan. 

The treatment approach well-opted for hemorrhoids with minimal side effects and a fast recovery rate is Ayurvedic medicinal therapy i.e. Kshara karma therapy, which is considered to be the best approach for treating hemorrhoids.  This therapy uses a cauterization procedure with a herbal blend of thread that cuts off the blood supply to the affected vein, allowing hemorrhoids to shrink over the next 7 to 10 days and detach on their own. 

The Ayurvedic treatment approach depends on the dosha predominance and severity or grading of hemorrhoids, individuals are advised to take specific medications to balance aggravated dosha while recovering along with some healthy dietary and lifestyle adjustments to support healing in post-treatment care.

  1. Dosha or Body constitution analysis is important when it comes to post-treatment to ensure specific herbs support postoperative healing. It’s also possible you may need to make some permanent changes in diet, exercise, and other factors to avoid future hemorrhoids.
  2. Cauterization or Agni karma on external hemorrhoids using infrared heat is done to lessen the chances of recurrence of the hemorrhoids. Cauterization might produce some pain.

Kshara treatment gives off the impression of being a safe option for the management of hemorrhoids, yet there is a potential for minimal side effects in some cases. Application of kshara or caustic powder paste or kshar sutra ligation blended over a thread for seven days aids in the shrinkage of the hemorrhoids. There is no relevant record of potential side effects being appeared during this treatment. Ayurvedic scholars have concluded that this treatment would be best for first-and second-degree hemorrhoids. In kshara sutra therapy or chemical cauterization, one gets side effects free treatment with the post-recovery period within 21 days and has no antagonistic impacts or difficulties.

This sort of treatment may expect five to six medicinal approaches over several weeks before it has any kind of effect. Indeed, the dosha predominance will be considered before treatment.

Post Care Treatment Guidelines:

A: Preventive Guidelines After The Treatment

Ayurvedic hemorrhoid treatments like the application of kshara paste and Kshara Sutra ligation have been shown to be safe and effective. severe complications after hemorrhoid surgery are rare. But,  cauterization procedures and surgical procedures have a much higher risk. Possible side effects include:

  1. damage to tissue
  2. bleeding
  3. pain
  4. infection
  5. shock
  6. leakage of stool
  7. recurrence of hemorrhoids

To avoid the above-mentioned complications, 

  1. Take just a fluid eating regimen before six hours of the method and favor a semi-solid eating routine following 3-4 hours. 
  2. From the next day, clean up and take a warm sitz bath at least thrice for 3 weeks. 
  3. Follow proposals of the doctor as in the use of Triphala Guggulu tablets and Haritaki Churna at sleep time with luke-warm water, for an additional fourteen days. 
  4. Application of Jatyadi Tailam two times every day after sitz bath and a few analgesics can be taken if there should be an occurrence of any agony or pain.
  5. It is encouraged to remain active & dynamic by taking small walking strolls while the treatment is ongoing. 
  6. Take fiber-rich food and mellow laxatives every day to stay away from hard stools and have unmistakable clear bowel movements consistently.
  7. Following a few days of medical procedure, one can restart normal nourishments and bit by bit increase the measure of fiber in the eating regimen. 
  8. Avoid significant distance driving and traveling that can be avoided.
  9. Also, avoid prolonged sitting or standing.
  10. Maintain a strategic distance from exhaustive exercises that incorporate running, jogging and cycling on slopes for fourteen days after the medical procedure.

Recovery from hemorrhoid surgery is a gradual process. Recovery time varies depending on the procedure of general health, age, and other factors. 

Post-treatment protocol involves mainly precautionary measures;

  1. After the hemorrhoidal management surgery, if one experiences minimal bleeding, pain and burning sensation for 1-2 weeks. Don’t worry, these are all part of the healing process.
  2. Ignore a false sensation of defecation or heaviness which can be up to 3-4 weeks. Practice Kegel exercises i.e. contraction and relaxation of anal opening 3-4 times a day to reduce that false sensation of defecation.
  3. Take at least 2 glasses of water and a small walk to feel the urge and pass soft stools in the morning.
  4. To keep the anal area clean, take sitz baths (sit in warm water for 15-20 minutes) at least 3-4 times a day and after each bowel movement.

B: Lifestyle Guidelines Post Treatment

  1. Avoid straining during defecation: The main causative factor in anorectal diseases such as piles, fissure in ano, Fistula in ano etc. is constipation due to sluggish digestion & metabolism that results in excessive straining during the act of defecation.  A better way to avoid this is to drink 1 or 2 glasses of lukewarm water and go to the toilet only when there is a feeling of adequate pressure for defecation.
  1. Caring for anal hygiene
    • Keep the anal area clean and dry. 
    • After each bowel movement has a sitz bath or takes a shower to clean and soothe the anal area. Use soft gauze, or wear loose cotton based undergarments to keep clean.
  1. Activity Restrictions 
    • Avoid lifting, pulling, and strenuous activity, straining during bowel movements or when urinating. 
    • The recovery period may take  1-2 weeks and to return to work and other activities around 7 to 10 days after hemorrhoid removal surgery. 
  1. Tags after hemorrhoid surgery: One might notice skin tags around the anal area that feel like hemorrhoids. Some of this is due to postoperative swelling which will reduce with time.

C.  Dietary Guidelines Post Treatment

  1. Take food items rich in fibers and easily digestible to avoid ‘Manda Agni’ (sluggish digestive fire) and constipation.   For more details kindly read the author’s blog on diet management for anorectal patients.
  2. Avoid prolonged sitting and/or standing. Be ambulatory. Do regular morning and/or evening walks. It promotes healing and leads to adequate drainage in fistula patients.
  3. Though kshara sutra procedure is minimally invasive, a few patients may feel some pain after kshara sutra treatment like felt in other surgical procedures. Such patients should;
  4. Avoid alcohol, smoking, tobacco chewing, excess tea or coffee and excessive spicy or junk food items.


Will there be any bleeding post piles treatment?

After post-treatment, one might have complaints of slight bleeding from the area where cauterization was done, this is quite normal. The amount of bleeding may range from drops to a few ml per day. The bleeding will cease with passing days. Contact the physician, if having more than the expected bleeding that lasts longer than a week.

Will there be pain after the postoperative management? If yes, what should I do to ease it?

Haemorrhoidal management care with kshar sutra ligation has minimal pain occurrence for a few days, but the pain and discomfort will ease. Take mild laxatives like Triphala powder or haritaki powder for soft passage of stools and perform a sitz bath twice a day with warm water followed by application of Jatyadi tailam.

What precautionary measures should be taken when I go to the toilet?

Proper diet and lifestyle along with healthy toiletry habits to avoid constipation i.e. hard stools are a must to reduce excoriating pain while defecating. Avoid excessive straining while defecation, pass stools only when having the urge and use stool under the feet to mimic a squatting position while using the western toilet for relaxing the abdominal and pelvic muscles while emptying bowels. The main aim is to have loose feces, prevent straining and therefore reduce pain. 

What are the anal hygiene measures needed to be followed post-treatment? 

It is important to maintain the affected anal area to be clean and hygienic. Gently bathe the area in a warm sitz bath and wipe by tapping with a soft cotton cloth only. Apply Jatyadi or kasisadi thailam locally to ease pain and prevent any postoperative infection. Avoid any use of soap or salt in the water until the wound has healed. 

What is the recovery period rate and when can I return to work?

 The recovery period usually lasts 1-2 weeks but it is recommended to have a week to 10 days off work. Avoid any strenuous activity such as heavy lifting, exercise or running during the first week or so. Build up to the normal level of activity gradually. 

Will my hemorrhoids come back? 

The recurrence rate of hemorrhoids with kshara therapy is very minimal. However, the chances of this happening can be reduced by taking several simple steps such as;

  1. Have soft stools to prevent excessive straining.
  2. Follow a healthy diet, with lots of high-fibre foods like cereals such as muesli, brown rice and other fruit and vegetables. 
  3. Remain hydrated and drink lots of fluids, about three litres each day for avoiding constipation. 
  4. Avoid prolonged sitting on the toilet for too long and try not to strain when passing stool. 
  5. Go to the toilet when you feel the urge to pass stool and don’t suppress the urge.
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