Dr Ashwin Porwal, Author at Blog

May 14, 2021September 22, 2021

Emergency Surgeries during Covid

One of the challenges in health care during the ongoing covid-19 pandemic has been emergency surgeries. In a time wherein there was no clear guideline, managing emergency surgeries was a huge challenge. There were papers from the western world suggesting 25% morbidity in surgeries during the covid pandemic. The guidelines on pre-op testing for covid 19 were not clear.

There is tremendous fear amongst patients to seek immediate medical consultation during the ongoing pandemic. As a result of this most of the patients are presenting at the hospital in late-stage or severe pain.

This was noticed in the majority of the patients during the lockdown period. This was noticed in patients suffering from piles & fistula.
“Almost all the piles’ patients presented with severe pre-rectal bleeding or in severe pain,” says Dr Ashwin Porwal.
They were operated on with minimally invasive Laser Haemorrhoidoplasty under universal precaution.

“Many patients of Fistula in Ano presented with abscess due to late presentation. They were operated under emergency with minimally invasive DLPL laser surgery for fistula”, says Proctologist Dr Ashwin Porwal at Healing Hands Clinic.

There were 4 cases of Fourniers gangrene with uncontrolled diabetes with early sepsis. Emergency ambulance pick-up was arranged for such patients during the lockdown. Early surgery could prevent severe sepsis with faster recovery, Says Surgeon Dr Paresh Gandhi.

“All patients were operated under spinal anaesthesia to decrease the risk of transmission due to covid pandemic”, says anaesthetist Dr Nitin Nachane.

“Open 3D mesh repair was preferred over the laparoscopic repair for obstructed hernia considering the greater risk of transmission during the covid pandemic”, says Laparoscopic Surgeon Dr Deepak Kulkarni.

Many of the outstation patients who were operated on in early March for complex fistula couldn’t come for follow up due to lockdown. They developed premature closure of the wound. Which eventually developed into pus leading to an abscess. Evaluation under anaesthesia was performed on all such cases to drain the pus. This normally would not have happened if the follow-up dressing was not skipped.

Contracting Covid from asymptomatic patients is always a risk amongst health care workers. To minimise this strict universal precaution were taken. As a result of this none of the hospital staff contracted covid 19.

Universal Precautions for Covid
1.PPE kits were used for OT staff
2.Social distancing was maintained throughout from consultation to surgery.
3.Sanitisation was practised from door to door
4.Daily sanitisation of Rooms and hospital
5.Private rooms were allocated to all patients.
6.Only one attendant per patient was allowed
7.Patients were trained to use the mask in the right way.
8.Screening of all patients before entering the waiting room. History of travel, cough, fever was ruled out. Temperature and SPO2 check for all the patients on admission

Source: Healing Hands Clinic

One such case with uncontrolled diabetes presented in a very late stage due to lockdown.
The patient was suffering from a complex recurrent fistula for the last 1 year.
Excessive sitting at one place and limited activity due to lockdown was the possible cause for his recent increase in blood sugar levels. He started having pain in the buttocks 5 days before coming to us in an emergency. He self-treated the condition considering it as piles. Severe pain with fever prompted him to visit us. He underwent emergency FiLaC surgery for fistula and the abscess was drained. He took a longer time for the healing.

Questions & Answers
1.Why patients with piles and fistula who did not seek medical care during lockdown are taking a long time to heal now?

Answer : Usually 70% of patients coming to us for piles are treated with medicines and diet as they are diagnosed in an early stage. But now they are presenting in the late stages of the diseases with symptoms like severe pain or bleeding. Once the piles are in grade 3 or grade 4, medical management has a limited role. We are offering them Laser Surgery for same.
Patients with fissure who will normally respond to medications in 2 weeks are now taking minimum of 4-6 weeks for recovery with medications.
Patients suffering from Fistula are presenting in severe pain or fever due to abscess. Such patients need emergency surgery. But because of the active infection, healing is slow after surgery. Few complex cases might take 2-3 Months for complete healing after complex fistula surgery. Few patients need weekly follow up after fistula surgery but they are scared to travel due to lockdown. All these factors delay the healing and recovery time.

2.How seeking medical care in time helps in faster recovery?

Answer : Early diagnosis is the key to medical success and good quality of life. If piles are diagnosed in grade one or early grade 2 they can be cured with a specialised kit called PILOKIT which is 15 days course. It consists of innovative pilospray for instant relief without touching the sore anus. Pilotab for inflamed piles and Constitab for constipation.
Also, the uncomplicated fistula will heal very fast with laser surgery.

3.What are the various types of complications that patients with piles and fistula land up with when they delay treatment?

Answer : Patients in grade 3 and grade 4 piles will land up in severe per rectal bleeding with drop-in Haemoglobin. We saw many patients in bleeding who were having comorbid cardiac conditions and were taking blood thinners.
Few patients with abscess in existing fistula presented with early sepsis due to uncontrolled diabetes.
Few patients presented in severe sepsis with a morbid condition Called as Fourniers gangrene.

4.Is there any subset of patients who could have recovered with conservative treatment but now they had to undergo surgery as the disease progressed due to delay in seeking medical care during a lockdown ?

Answer : Most the patients with Acute fissure if treated in time are cured with medications.
But untreated fissure with severe pain or when it gets complicated into abscess or fistula will need surgery.

Dr Ashwin Porwal
Consultant ColoRectal Surgeon
Founder Healing Hands Clinic

August 6, 2020September 22, 2021

Complications rise among piles patients in shutdown

A sizable number of people with piles and fistula are taking longer to get cured as most of them are delaying medical care in the wake of the coronavirus triggered lockdowns, resulting in complications.

“Usually, 70% of patients with piles are treated with medicines and dietary changes as they get diagnosed in an early stage. However, owing to the extended lockdown in the wake of the Covid-19 pandemic, a sizable number of patients are presenting in late stages of the disease with symptoms like severe pain and bleeding,” said consultant colorectal surgeon Ashwin Porwal of Healing Hands Clinic.

Once the haemorrhoids (piles) are in grade III or IV stages, medical management has a limited role.

“Most of these patients with progression of piles are being treated with laser surgery when medication and lifestyle modifications could have been enough to do the trick if they had approached us early,” Porwal said.

Similarly, patients with an anal fissure, a small tear or crack in the lining of the anus, who normally respond to medications in two weeks are now taking a minimum of 4-6 weeks for recovery with medications. “Patients with fistula, a tunnel that runs from inside the anus, are also approaching us after developing severe pain or fever due to abscess (collection of pus). Quite a few of them even required emergency surgery,” Porwal said.

Many of the outstation patients who were operated in early March (before the lockdown) for complex fistula couldn’t come for follow up due to the lockdown.

“They developed premature closure of the wound, which developed into pus leading to an abscess. This would not have happened if the follow-up dressing was not skipped,” laparoscopic surgeon Deepak Kulkarni said.

Healing is slow in such patients even after surgery.

“Patients need weekly follow up after surgery. But the frequent lockdowns made them reluctant to venture out for follow up, delaying the healing and recovery,” said anaesthetist Nitin Nachane.

Contracting Covid-19 from infected but asymptomatic patients is always a risk for healthcare workers as much as other patients.

“To minimize this, strict universal precautions are being taken. Post-surgery, patients are put on immunity-boosting medications like Curcumin and vitamin D for two weeks. None of our patients have developed Covid-19 during hospital stays and even after the surgery so far,” Porwal said.

Experts also stressed against indulging in self-medication amid Covid-19 infection fears.

“It is always better to reach out to the medical practitioner via online or video chats or simple call,” an expert said.

Reference

December 31, 2019December 31, 2019

Pruritus Ani: The Embarrassing Itch

Itching of the skin around the anus can be agonizing especially if one is stranded in a public place with no escape in view. More often than not the cause behind this itch is easily addressed. Occasionally however, persistent severe itching can cause psychological stress to the sufferer and needs in-depth evaluation.

What is Pruritus ani?
Pruritus ani is defined as chronic, moderate to intense itching of the skin around the anal opening.
It affects 1-5% of the population and is more commonly found in men. Once itching occurs, it can lead to a vicious itch-scratch-itch cycle.

Causes of Pruritus ani

• Fecal Contamination

Prolonged contact of the skin with fecal matter can cause irritation with resultant pruritus. Inadequate cleansing can leave stool and sweat residue which acts as irritant. Most of these individuals have loose stools or mucous seepage. Abnormal anal sphincter relaxation can also cause soiling. This kind of itch is usually relieved by washing the area. However, underlying pathology, if any, needs to be addressed.

• Anorectal disorders

Anorectal conditions like Hemorrhoids (Piles) and Fissure can precipitate peri-anal itch. External hemorrhoids that are large can interfere with post-defecation cleansing. Internal hemorrhoids, on the other hand, can cause mucous seepage or fecal soiling and resultant pruritus. Anal Fissures can also cause itching due to inflammation. Anal Fistula or Fistula-in-ano with an external opening in the region, can lead to discharge of pus or fecal matter and consequent itching.

• Infections

Fungal infections are common in the area, especially among diabetics who are prone to Candidiasis. Infection with threadworms/pinworms is also common, especially among children. Viral infections can also cause pruritus

• Allergy

Chemicals found in creams, wet wipes, soaps etc. can cause Allergic Contact Dermatitis.

• Skin conditions

Psoriasis, lichen sclerosis, Paget’s disease, peri-anal Bowen’s disease etc. can also can pruritus ani.

• Other factors

Certain foods like caffeinated drinks, spices, peanuts, tomatoes etc. can cause peri-anal itching. Relief is attained within 2 weeks of stopping the causative food.
Aggressive cleaning can cause dryness of the skin and thus itching.
Psychological factors like anxiety, stress or depression maybe associated with pruritus ani.
Similarly, aggressive cleansing can cause dryness in the area and itching.

Dealing with Pruritus ani

To get rid of peri-anal itching, the underlying cause needs to be addressed. One should wear loose, cotton clothing, especially at night, which gives an opportunity for ventilation. Following a bowel movement, the area should be gently cleaned with water or simple tissue moistened with water or with peri-anal wipes. One should avoid the use of soaps in the area. Associated symptoms, if any, point to an underlying pathology. Anorectal conditions like piles, fissure and fistula are treated by a Proctologist. Peri-anal skin conditions, infections and allergies are treated by a Dermatologist.

December 12, 2019September 22, 2021

Novel Laser Cure for Anal Fistula

Fistula-in-ano, a silent yet agonizing ailment, has always posed a treatment challenge to surgeons worldwide. The refractory nature of Fistula along with its tendency to recur continues to leave the best doctors perplexed. Consequently, those suffering from this condition find themselves anxiously searching for a definitive cure. In light of this scenario, Dr. Ashwin Porwal, renowned Proctologist and founder of Healing Hands Clinic, India, set out on devising a technique called DLPL that provides an assured and lasting cure.

Anal Fistula aka Fistula-in-ano is an abnormal track that forms between the anal canal and the skin around the anus. It is commonly associated with a collection of pus in the bottom area called Rectal Abscess. Symptoms may be due to the underlying Abscess or due to Fistula per se. This includes throbbing pain, oozing of pus/watery fluid, swelling, itching and foul odor. Diagnosis is confirmed by a simple test called Proctoscopy. For a detailed study of the abscesses and track branching, Dr. Porwal introduced 3D Endo-anal Imaging. This imaging can also be used intra-operatively thus increasing the precision of the surgery.

Until recent times, Fistula was treated using different techniques like Fistulectomy, VAAFT, LIFT, Ksharsutra, Fistula Plug etc. However, these conventional techniques were quite painful or had high recurrence rates. Being a Proctologist, Dr. Porwal would come across a large number of previously treated Fistula cases who were rendered helpless after recurrences. Subsequently, he developed his own technique DLPL (Distal Laser Proximal Ligation). In this procedure, any abscess cavity along with the internal opening is first excised. This is followed by the closure of the distal tract. The proximal part of the fistula track is then sealed with the Laser energy. With the radially emitting fiber of the laser, energy is applied circumferentially to the track ensuring it’s complete ablation. Complete healing takes about 8 weeks on average.

Using this technique Dr. Porwal has treated Complex and Recurrent Fistulae with noteworthy success. Patients from across the globe come to Healing Hands Clinic in the hope of a cure. Dr. Porwal has presented numerous research papers at national and international conferences. The benefits of DLPL will definitely bring hope to despondent patients of Fistula who muddle along for years in search of a cure.

September 10, 2019September 22, 2021

Understanding Constipation and It’s Treatment

With a lot of humor centered around it, constipation is as much a topic of laughter for the audience as it is an agony for the sufferers. Constipation, basically, is a change in your normal bowel movements; going less frequently than you usually do, passing hard, dry stools, or straining when you defecate. In chronic cases it can lead to complications like piles, fissure and prolapse, and hence choosing to seek advice is much wiser than accepting it as an inevitable pattern of your digestive system.

A lot of times attempts at getting rid of constipation fail as treatment is unidimensional, being directed only towards the obvious reason, when it is in fact,caused by an array of factors. Taking this into consideration, Healing Hands Clinic, a comprehensive center for digestive diseases offers a multi-pronged approach for curing constipation. For those in whom it is caused by an unhealthy lifestyle, there is MCDPA, a treatment strategy formulated by Dr Ashwin Porwal, Founder of the clinic and amongst India’s leading proctologists. This therapy includes a combination of herbal laxative medicines, nutrition counselling, physiotherapy to strengthen the muscles of the pelvic floor and Ayurvedic oil therapy. This treatment strategy proves extremely beneficial when followed with compliance. For those in whom constipation is an occasional problem or who are seeking a detox, there is Colon Hydrotherapy, a cleansing technique that uses temperature and pressure-controlled water to flush out the intestines. The clinic is further equipped with Biofeedback Therapy to train the pelvic muscles for proper evacuation.

Dr Porwal, who introduced 3D Endo-anal Imaging in India says that this test helps to diagnose more complicated causes in chronic sufferers. In cases where there is an anatomical problem like rectocele or for those having Obstructed Defecation Syndrome, there is hope in the form of STARR surgery, a technique that provides excellent results.

For appointments:
Healing Hands Clinic
Pune Station / Tilak Rd: 88882 88884
Wanowrie: 88885 22226
Baner: 88886 22221
Chinchwad: 88882 00004
Chakan: 88882 96666
Kothrud: 85759 99993
Website: www.healinghandsclinic.co.in
Email: info@healinghandsclinic.co.in

June 15, 2019September 22, 2021

Laser to cure pilonidal sinus

Extended hours of sitting, either in front of the computer or preparing for competitive exams has led to rise in the incidence of Pilonidal Sinus amongst youngsters. Notoriously called as Jeep Driver’s Disease, this condition that is found in the tailbone area, is now a trouble for the young urban population. Proctologists at Healing Hands Clinic shed some light on this topic.

What is a Pilonidal Sinus?
The word Pilonidal means a nest of hair within a sac, whereas sinus tract is a narrow passage anywhere within the body. Thus, Pilonidal Sinus is a cyst (small sac) or tunnel in the skin that usually develops over the tailbone at the top of the cleft between the buttocks. The cyst usually contains hair and debris.

What are the causes of this condition?
The condition is more common in males, especially young adults. It’s seen in people who sit for long hours at a stretch, for ex. students, IT professionals, drivers. Men with thick, curly and coarse body hair are especially susceptible. Having a deep cleft between the buttocks also makes one prone to it. Obesity and family history are other causes.

What are the symptoms?
A person suffering from Pilonidal Sinus would usually have recurring episodes of pain or swelling in the tailbone area. There may be a yellowish pus-like or bloody discharge that may be foul-smelling. Sometimes, there is no discharge but a painful lump under the skin of that area. Certain activities like riding a bicycle or doing sit-ups may be uncomfortable.

How is it treated?
Thanks to advances in medicine, Laser is proving an excellent modality of treatment. The procedure called Laser Pilonidotomy is minimally invasive with faster wound healing as compared to the older techniques. Patients are discharged home the same day; they can perform all their chores and join office by the next day.

Healing Hands Clinic is certified Centre of Excellence in Proctology by world-renowned colorectal surgeon, Dr Antonio Longo.

For appointments:
Healing Hands Clinic
Pune: 8888288884
Navi Mumbai: 88881 66667
Mumbai: 8888266664
Nasik: 8888366662

Website: www.healinghandsclinic.co.in
Email: info@healinghandsclinic.co.in

June 15, 2019November 27, 2021

What you need to know about Piles

Everything you need to know about piles | piles symptoms | piles treatment | piles
cure | piles surgery

Studies suggest that by age 50, about half the population has experienced one or more symptoms of Piles. These include itching, bleeding on passing stools, pain and prolapse (where a mass is felt in the anal area). Piles aka Hemorrhoids can significantly disturb well-being of an individual.

Causes

● Long standing constipation
● Hard stools
● Pregnancy
● Excessive straining during defecation
● Chronic cough

Hemorrhoids are swollen veins of the rectum and anus. When veins of the lower rectum swell, they are called Internal Hemorrhoids, which are typically associated with painless bleeding. When the swelling occurs in veins under the skin around the anus, they are called External Hemorrhoids and cause considerable discomfort.

Proctology is a specialty of medicine that deals with conditions like piles, fissure, fistula, constipation, pilonidal sinus etc. Healing Hands Clinic founded by Dr Ashwin Porwal aims to provide cutting-edge treatment for these conditions. Hemorrhoids are treated depending upon their grade. Grade 1 which is the earliest stage is treated holistically by MCDPA, which is a combination of herbal medicines, pelvic floor physiotherapy and dietary changes. Grade 2 and 3 are associated with mass coming out of the anal opening which goes back spontaneously or with manipulation respectively. These grades are treated using Diode Laser by a technique called Laser Hemorrhoidoplasty. Laser provides a quick, effective and safe treatment option. When the disease reaches grade 4, the protruded mass (prolapse) remains outside the body. At this stage, Stapler Hemorrhoidectomy is done. Stapler surgery ensures complete removal of protruding mass and leaves no chance for recurrence. When done by an expert, these procedures don’t harm the anal sphincter, thus control over motion remains intact. Patient can go home within 24 hours and get back to routine work by 3rd day.

For appointments:
Healing Hands Clinic

Website: www.healinghandsclinic.co.in
Email: info@healinghandsclinic.co.in

April 12, 2019September 22, 2021

Here is what you need to know about the new treatment for fistula

With technological advances in medical field, we are witnessing great developments in treatment of various diseases. These advancements are further validated by impeccable medical expertise and that is exactly what super-speciality Proctology centre Healing Hands Clinic offers to all its patients. Proctology is a branch of medicine that deals with anorectal conditions like Piles, Fistula, Constipation, Fissure, Pilonidal Sinus and Prolapse amongst others.
What Is an Anal Fistula?
In its simplest form, it is a tunnel with one opening inside the lining of your anus and another opening in the skin of your butt. The noticeable symptoms include opening in the skin of the buttock with discharge of blood or foul-smelling pus, redness and swelling, and pain.
Laser: An assured treatment modality for Fistula
Fistula is a complex disease. It hardly ever recovers on its own, and once formed, needs some degree of surgical intervention. Ultimately, the aim of any fistula treatment is, firstly, to get rid of the tract while saving the sphincter muscle. Secondly, the treatment should be such that chances of recurrence are minimal. The latest improvisations on the conventional ways to treat fistula include procedures like FiLaC (Fistula Laser Closure) and DLPL (Distal Laser Proximal Ligation). The principle behind these techniques is to use defined energy to circumferentially vaporize and close the fistula tract while sparing the muscle around it. Laser is quick, precise, and the post-procedure healing is excellent. DLPL provides promising results in complicated and recurrent cases.
Fistula is notorious for its recurrence or its tendency to come back after treatment. However, a large number of Recurrent Fistulas have been successfully cured at Healing Hands. The statistics so far state that on an average there are about 30% chances of recurrence in treated cases of Fistula. At Healing Hands, the numbers are at a mere 2% which clearly exhibits a sturdy success rate of the surgical expertise offered here. Research papers on DLPL have been presented at various national and international conferences and the procedure has received a thumbs-up from the surgical community.

For appointments:
Healing Hands Clinic
Pune Station / Tilak Rd: 88882 88884
Kondhwa: 88885 22226
Baner: 88886 22221
Chinchwad: 88882 00004
Chakan: 88882 96666
Website: www.healinghandsclinic.co.in
Email: info@healinghandsclinic.co.in

May 14, 2018September 23, 2021

बद्धकोष्ठता

मध्यंतरी एक बॉलिवूड ब्लॉकबस्टर चित्रपट आला होता. त्या चित्रपटाच्या मध्यवर्ती संकल्पनेत ‘बद्धकोष्टता’चा विषय असल्याने प्रेक्षकांचं निखळ मनोरंजन झालं खरं परंतु हा त्रास ज्यांना होतो, तेच त्याची व्यथा समजू शकतात. आतड्यांची हालाचालीत बिघाड झाला की बद्धकोष्ठतेचा त्रास सुरू होतो. हा त्रास सुरू झाला की, साधारणपणे तुम्ही जितक्यावेळा शौचास जाता त्यापेक्षा कमी वेळा जाऊ लागता, मलविसर्जनाच्यावेळेस ताण येऊ लागतो, शौचाची जागा कोरडी होते. काहीवेळा तर मुळव्याध, फिशर, सूज येणे असा गंभीर स्वरूपाचा त्रासही होतो. पण आपण बद्धकोष्ठता ना म्हणजे ‘बिघडलेली पचनसंस्था’ असं सरळसोट विचार करून निमूट सहन करत राहतो. खरंतर उगीच असं सहन करत राहण्यापेक्षा बद्धकोष्ठतेवर उपाय करणं अधिक भल्याचं नाही का!

बहुतांशवेळा बद्धकोष्ठतेवर जे उपचार केले जातात त्यातून आराम मिळतच नाही, अशी एक ओरड असते. ते खरं आहे कारण बद्धकोष्ठता होण्यामागे निरनिराळे घटक कारणीभूत असतात आणि आपण त्यातल्या कुठल्यातरी एकाच घटकाचा विचार करून उपचार करतो. त्यामुळे आराम मिळत नाही उलट त्रास गंभीर होतो. हीच गोष्ट ध्यानात घेऊन, बद्धकोष्ठतेपासून कायमस्वरूपीचा आराम मिळवून देण्यात ‘हिलींग हॅण्डस क्लिनीक’ बहुविध उपचारपद्धती देण्यात प्रसिद्ध आहे. हिलींग हॅण्डस क्लिनीकमध्ये पचनसंस्थाशी निगडीत आजारांवर सर्वंकष उपचार केले जातात.

आजच्या धकाधकीच्या जगण्यात आपल्या सगळ्यांचीच जीवनशैली बिघडली आहे. या बिघडलेल्या जीवनशैलीमुळे जर बद्धकोष्ठता होत असेल तर या क्लिनीकचे संस्थापक आणि भारतातील अत्यंत नावाजलेले प्रॉक्टोलॉजिस्ट डॉ. अश्‍विन पोरवाल यांनी स्वत: एक उपचारपद्धती शोधली आहे. एमसीडीपीए असं याच उपचारपद्धतीचं नाव आहे. या उपचारपद्धतीत दोन तीन गोष्टी एकत्रित केल्या आहेत. त्यात क्लिनीकमध्येच बनविण्यात येणारे वनौषधींची रेचक औषधांसोबतच आपल्या सदोष आहारपद्धतीत बदल करण्यासाठी समुपदेशन, स्नायूंच्या बळकटीसाठी फिजियोथेरेपी आणि आयुर्वेदीक तेलमसाज अशी विविध उपचारपद्धती एकत्रित वापरून उपचार केले जातात. योग्यरितीने हे उपचार घेतल्यास त्याचा अत्यंत चांगला फायदा होतो. ज्यांना बद्धकोष्ठतेचा सातत्याने त्रास होतो त्यांच्यासाठी कोलोन हायड्रोथेरेपी ही क्लिनझींग तंत्र वापरण्यात येते. या तंत्रात तापमान व दाब नियंत्रीत पाण्याचा वापर करून पोट साफ केले जाते.

डॉ. पोरवाल यांच्यासोबत दीर्घकाळ काम करणारे डॉ. नेहल पटेल हे या उपचारांविषयी म्हणाले, ‘गंभीर त्रास होणार्‍या रूग्णांची नेमकी आणि गुंतागुंतीच्या कारणाचं निदान करण्यासाठी एमआरआय डिफेकॉग्राफी ही तपासणी केली जाते. ज्यांना शाररिक समस्या असतात जसे की गुदाशयाचा अर्ंतराळ किंवा गुदाशयच खाली सरकणे (रेक्टोसेल) किंवा मलविसर्जन न होणे अशा रूग्णांसाठी स्टारर (एसटीआरआर) सर्जरी उपयुक्त ठरू शकते. या सर्जरीने आराम मिळाल्याचं रूग्ण सांगतात. स्त्रियांच्याबाबत बद्धकोष्ठता ही मुत्राशयाशी निगडीत असते. अशा स्त्रियांना खोकताना किंवा व्यायाम करताना त्यांना लघवी होते. अशा घटनेसाठी पटेल पॉप्स (पीओपीएस) ही सर्जरी सुचवतात. विशेष म्हणजे भारतात सर्वात पहिल्यांदा ही सर्जरी ‘हिलींग हॅण्डस क्लिनीक’ने केली. या सर्जरीमुळे खाली गळलेले अवयव त्याच्या जागी पुन्हा सरकवून त्याची कार्यप्रणाली पुन्हा सुरू होते. म्हणूनच या सर्जरीने किती तरी स्त्रियांचं दुखणं कमी झालं आहे.

May 14, 2018September 23, 2021

मुळव्याध, फिस्तुला, पिसोनियस सायनसचे सोपे उपचार

मुळव्याधाचा त्रास होतोय असं म्हणणार्‍या माणसांची संख्या दिवसेंदिवस वाढत आहे. दोनात एक असं याचं गुणोत्तर असून ही धोक्याची घंटा आहे. मुळातच आयुष्याच्या कुठल्या ना कुठल्या टप्प्यावर प्रत्येकालाच मुळव्याधीचा त्रास होतो. मुळव्याधीचा त्रास स्वत:बाबत असो वा कुटुंबातल्या अन्य कोणाबरोबर रक्त जाणे हा घटक तर कोणालाही घाबरवणाराच आहे. मुळव्याध बरा करणारा सोपा उपचार म्हणणार्‍या असंख्य पद्धती बाजारात आहेत. त्यातील काही पद्धतींमध्ये तर वैज्ञानिक दृष्टीकोन, वैज्ञानिक सफाईदेखील नाही. त्यामुळे कोणती उपचार पद्धती स्विकारावी याबाबत साहजिकच रूग्णांचा गोंधळ उडतो. मुळव्याध आणि फिस्तुला बरं करण्यासाठी पारंपरिक पद्धतीने केली जाणारी सर्जरी तर वेदनादायक आहेच परंतु त्यातून रिकव्हर होण्यासाठीसुद्धा दीर्घकाळ लागतो.

सध्याच्या या प्रचलित चित्राचा विचार करून कोलोरेक्टल सर्जन आणि हिलींग हॅण्डस किल्निकचे डॉ. अश्‍विन पोरवाल यांनी मुळव्याध, फिस्तुला आणि इतर गुदाशय व मलमार्गाशीसंबंधीत आजारांवर उपचार करणारी पद्धती शोधली आहे. या पद्धतीत मुळव्याधीसाठी लिओनार्डो लेसर ट्रीटमेंट वापरी जाते. या पद्धतीने रूग्णाला तातडीने फरक पडतो आणि मुख्य म्हणजे आजार पुन्हा उद्भवण्याची शक्यताही खूप कमी आहे. कुठल्याही कापाकापीशिवाय होणारी आणि वेदनाहीन असणारी उपचारपद्धती आहे. त्यामुळे रूग्ण पुढच्या ३ ते ५ दिवसांच्या आरामानंतर नियमित कामे करू शकतात. लिओनार्डो लेसर पद्धतीचा फायदा फिस्तुला झालेल्या रूग्णांनाही होतो. पिसोनियस सायनस हा आजार तर सहजासहजी बरा होत नाही मात्र याही आजाराबाबत लेसर ट्रीटमेंट काम करत असल्याचे दिसत आहे.

भारतातील प्रणेते आणि नामवंत प्रोक्टोलॅाजिस्ट डॉ. अश्‍विन पोरवाल यांनी आत्तापर्यंत मुळव्याधीचे हजारो रूग्णांना बरे केले आहे आणि फिस्तुल्याच्या अत्यंत गुंतागुंतीच्या केसमधील रुग्णांनाही यशस्वीरित्या बरे केले आहे. डॉ. पोरवाल म्हणाले, ‘शौचासाच्यावेळी रक्त जाणे ही निश्‍चितच भीतीदायक बाब आहे. त्यामुळेच आम्ही मुळव्याधीसाठी लेसर हिमोर्‍होडोप्लास्टी (एलएचपी) आणि फिस्तुलासाठी फिस्तुला ट्रॅक्ट लेसर क्लोजर या उपचारपद्धती शोधल्या आहेत. प्रोक्टोलॉजीतील या दोन्ही पद्धती अत्यंत आधुनिक असून माझ्या आजपर्यंतच्या अनुभवाचा विचार केला तर मुळव्याधीची नुकतीच सुरवात झालेल्या रूग्णांसाठी तर या उपचारपद्धती अत्यंत सुरक्षित आणि विश्‍वसनीय आहेत. फिस्तुलाच्या संदर्भातही ही पद्धत उपकारक ठरली आहे. लिओनार्डो लेसरपद्धतीने आम्ही अगदी अवघड केसेसमध्ये यश मिळवलं आहे. ज्या केसमध्ये इतर उपचारांनी फरक पडला नाही अशाही केसमध्ये ही लेसरपद्धत काम करून गेली. आपल्या आजच्या धांदलघाईच्या जीवनशैलीत प्रत्येकालाच त्वरित आणि परिणामकारक उपचार हवे असतात. लेसरपद्धती नेमकं तेच काम करते.’

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