Constipation is a difficult problem. Not because we cannot treat it but we hesitate to get treated in the first place. Our diets and food habits are increasingly becoming westernised. Which is resulting in low intake of fibre and increased consumption of refined carbohydrates. All of which causes constipation. Which in turn results in perianal problems such as Piles, Fissures, Fistulae, and Abscesses etc. In the third trimester of pregnancy, the baby’s head descends into the pelvis and can result in pressure in that area resulting in piles. As a General Surgeon, I regularly see people suffering from all these perianal conditions. But usually people come to a surgeon as a last resort.

In India, especially, women suffer a lot before seeing a doctor. They hesitate to tell about their problems, even to their family or husbands. Also they hesitate in consulting male doctors. And keep postponing treatment while suffering in silence. Agreed that perianal diseases like piles, fissure, fistulae are not life threatening. But they are so painful and inconvenient! Why go through all this when they are all amenable to simple treatment?