Talking to your patients about piles

As a doctor and a gastroenterology specialist, you would have seen hundreds of patients who present themselves with pain near their anus, inflammation, itching, and most likely piles. We are sure that you would have noticed that most of them are very hesitant in talking about their symptoms and feel uncomfortable during a physical examination.  As a friendly doctor, here are few things you can follow to make a piles patient feel comfortable and confident with you while talking, examining, or when treating.

Make them feel comfortable with little friendly talk

Listening to your patients is most important as per Dr. Karthik Gunasekaran of Laser Gastroenterology Clinic, T Nagar, Chennai. The more you listen to them, the more they start opening up about their problems. As they start opening up, you can ask more questions about their problems and how it has affected their lifestyle.

Once that is done, you can tell them that piles is a very common issue and nearly 50% of the people get piles at some point during their lifetime and in 90% of the cases surgery may not be needed. Make them feel that they are not alone or they don’t have to feel embarrassed for suffering from piles and their pain is soon going to go away.  As you talk to them, piles patients feel more comfortable and also cooperate well during physical examination or when diagnosing using other tools.

Talk to them after diagnosis about the various treatment options

The very first thing you must note is, NOT to use the medical terms that you have learned. They just go over the head of your patient. You must talk in plain English or any local language that is your patients can easily comprehend. Explain to them about the types of piles (internal and external) and how they come up. You can also tell them the type of piles they have and the treatment options including:

1. Rubber band ligation. The most common treatment where a rubber band is tied to the bottom of the piles to cut off the blood supply and arrest the growth.  As the piles die, they drop off, probably in a week to 10 days.

You must also let them know that there is a possibility of bleeding after a couple of days post putting up the rubber band and that is normal unless the bleeding is severe. Don’t hesitate to give your direct contact number so that the patient may feel more comfortable and confident after receiving the treatment.

1. Sclerotherapy. A chemical is injected into the piles that shrink them. The injection may hurt a little or you may not feel a thing.
2. Coagulation therapy. This can be done with infrared beam or laser or bipolar. On the whole, energy beams are used to harden the base of the piles which in turn stops the blood supply to the piles and they eventually drop off. Minor side effects and discomfort are common in these therapies.

Surgical options for treating piles

In the rest of 10% of the patients, surgery may be the only option to remove piles (in cases of severe and recurring piles). You may have to explain to them the type of piles and their condition and why surgery is the only and best option for them. Surgical options for piles include:

1. Hemorrhoid Removal (Hemorrhoidectomy) wherein the excessive tissue is removed. This can cause bleeding and the surgery is done under local anesthesia.
2. Hemorrhoid Stapling, a procedure done on internal hemorrhoids to block the blood flow to piles. This is a little less painful than hemorrhoidectomy.

Laser treatment for piles

As a doctor and gastroenterologist specialized professional you know that laser treatment for piles is effective in treating piles. Laser treatment for piles is relatively safer, scar-free, less painful, and has minimal blood loss. Postoperative care is also less and recovery time improves compared to conventional surgeries for piles.  If you are a gastroenterologist trained in treating piles using advanced laser technology, you will need to give the option of laser treatment to your patient and explain the merits of the procedure.  You can tell them that they will be able to get back to normal life in as little as a week as the surgery doesn’t involve any sutures and has more precision compared to other procedures.

Explain to the patient about the effects and side effects of the treatment and when they can get back to their normal life. Also, explain to them what they can expect and what they are expected to do during their recovery period after piles surgery.

Most important of all, you will also need to tell them the approximate cost of piles surgery and if their insurance can cover the cost. This can make them feel lighter on their pockets and highly likely to return for surgery.

On the whole, you will need to make them feel comfortable, less hesitant, and more confident about the problem, diagnosis, and treatment procedure including the cost. You may also check on them (directly or through one of your staff) on how they are doing and if they need any medical advice or having any unusual thing happening in the area of treatment.

A happy patient is more likely to give very positive feedback on social media and spread good about your treatment through word of mouth that can help you get more walk-ins.