BMDC Reg No: A-53971 Assistant Professor, SSMCH
Dr. Tanvir Ahmed Consultant Surgeon
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EVIDENCE-BASED PATIENT EDUCATION

Frequently Asked Questions

Explore clear, medically accurate explanations regarding anorectal conditions, minimally invasive laparoscopic surgery, recovery expectations, and chamber appointments.

While all three conditions affect the anorectal region, their anatomy and clinical presentations differ substantially:

  • Piles (Hemorrhoids): Swollen, inflamed vascular cushions in the anal canal. Symptoms primarily include painless, bright-red dripping blood during defecation and protruding lumps.
  • Anal Fissure: A sharp cut or tear in the sensitive lining of the anal canal, caused by passing hard, dry stools. Symptoms feature intense, sharp burning or knife-like pain during and for hours after bowel movements, accompanied by streaks of blood on toilet paper.
  • Anal Fistula: An infected abnormal tract communicating between the interior of the anal canal and the external perianal skin. It usually originates from an infected anal crypt gland or previous abscess, presenting with intermittent pain, perianal swelling, and recurring foul-smelling pus or bloody discharge.

Yes, absolutely. Gone are the days when traditional open excisional hemorrhoidectomy was the only option. Modern colorectal surgery emphasizes sphincter-sparing, minimally invasive procedures:

  • Laser Hemorrhoidoplasty (LHP): High-precision diode laser energy is delivered directly into the submucosal hemorrhoidal node without incisions, causing it to shrink while preserving the natural anal mucosa and continence muscles.
  • Stapler Anopexy (MIPH): A specialized circular stapling device removes excess prolapsing tissue above the sensitive pain line (dentate line), restoring anatomical position with virtually painless recovery.
  • Rubber Band Ligation & Sclerotherapy: Ideal outpatient modalities for early Grade I and II internal hemorrhoids requiring zero hospital admission.

Rectal bleeding (hematochezia) must never be ignored or casually assumed to be "just piles." Common causes include internal hemorrhoids, anal fissures, proctitis, diverticulosis, colon polyps, inflammatory bowel disease (IBD), and colorectal cancer.

You should consult a specialized surgeon promptly if:

  • The bleeding is persistent, dark, or mixed throughout the stool.
  • You experience an unexplained change in bowel frequency (chronic diarrhea alternating with constipation).
  • You have unintended weight loss, chronic fatigue, or low hemoglobin (anemia).
  • You are over 40 years of age or have a family history of colon or rectal tumors.

An anal fistula typically manifests as a tiny opening near the anus that repeatedly swells, bursts, and drains pus, blood, or watery discharge, followed by temporary relief until pressure builds up again.

Why early specialist intervention is crucial: Unlike simple fissures, a fistula virtually never heals with ointments or antibiotics alone because the internal source inside the anal canal remains infected. Delaying proper surgical treatment can cause a simple superficial fistula to branch into a complex "horseshoe" tract traversing deeper sphincter muscles, making future repair much more complicated. Modern laser fistula closure (FiLaC), LIFT procedure, and mucosal advancement flaps offer sphincter-preserving cures.

Laparoscopic Cholecystectomy is the modern gold standard for treating symptomatic gallbladder stones (cholelithiasis) and gallbladder inflammation (cholecystitis). Rather than a large 15–20 cm open incision, the entire diseased gallbladder is safely excised through 3 or 4 tiny keyhole punctures (5 mm to 10 mm) guided by an ultra-high-definition laparoscopic camera.

Recovery advantages:

  • Patients stand and walk comfortably within 4 to 6 hours after surgery.
  • Normal oral fluids and light meals resume the very same evening.
  • Over 90% of patients are discharged home within 24 hours.
  • Return to normal desk work and light routines takes just 5 to 7 days.

An inguinal hernia occurs when abdominal contents (fat or intestine) push through a weakened area in the lower groin muscles. Laparoscopic hernia repair (such as TEP or TAPP) places a lightweight, biocompatible polypropylene mesh behind the abdominal wall defect from the inside.

By placing the mesh in the preperitoneal space, natural intra-abdominal pressure presses the mesh firmly against the muscle wall, resulting in virtually zero tension, drastically reduced post-op groin pain, and exceptionally low recurrence rates. Both unilateral and bilateral (double) hernias can be repaired through the same three keyhole incisions.

Acute appendicitis is a medical surgical emergency. The classical presentation starts with dull, diffuse pain around the navel (umbilicus) that steadily migrates over 6 to 12 hours to the lower right abdomen (McBurney's point), becoming sharp, localized, and aggravated by movement, coughing, or walking.

Accompanying signs include nausea, vomiting, loss of appetite, low-grade fever, and inability to pass gas. Immediate evaluation with an abdominal ultrasound and blood counts is essential to perform a timely keyhole Laparoscopic Appendectomy before the inflamed appendix perforates or bursts into peritonitis.

Biofeedback Therapy is an advanced, painless, non-surgical training technique that uses computerized pressure sensors and visual electromyographic displays to teach patients how to consciously control, relax, and coordinate their pelvic floor and anal sphincter muscles during evacuation.

Conditions treated effectively with Biofeedback:

  • Pelvic Floor Dyssynergia (Anismus): Where muscles paradoxically contract instead of relax when straining to pass stool.
  • Severe Chronic Functional Constipation: Unresponsive to conventional laxatives or high-fiber diets.
  • Fecal Incontinence: Weakness in the anal sphincters leading to accidental gas or stool leakage.
  • Levator Ani Syndrome & Chronic Pelvic Pain: Spasmodic chronic pelvic floor discomfort.

International surgical guidelines recommend that average-risk individuals begin routine colorectal cancer screening at age 45 (or age 40 for individuals with personal or family histories of gastrointestinal polyps or cancer).

The gold standard screening test is a Colonoscopy, which not only identifies precancerous adenomatous polyps early but allows the specialist to safely remove them (polypectomy) before they ever turn into cancer. Any individual experiencing unexplained rectal bleeding, persistent alteration in bowel habits lasting over 4 weeks, pencil-thin stools, or iron deficiency anemia should be screened immediately regardless of age.

Surgical oncologic resection aims for complete tumor removal with clean margins and comprehensive regional lymph node dissection. Dr. Tanvir Ahmed performs oncologic colorectal resections including:

  • Laparoscopic Right & Left Hemicolectomy: For ascending, transverse, and descending colon tumors.
  • Laparoscopic Anterior Resection (AR) & Low Anterior Resection (LAR): For upper and mid-rectal cancers, striving for sphincter preservation wherever possible.
  • Total Mesorectal Excision (TME): The international surgical benchmark for rectal cancer clearance minimizing local recurrence risk.

Dr. Tanvir Ahmed conducts regular specialized evening and afternoon chambers across two premier centers in Dhaka:

  • Chamber 1: SIBL Foundation Hospital • 70 Green Road, Panthapath Crossing, Dhaka-1205. Visiting Days: Sunday, Monday & Wednesday (6:00 PM – 9:00 PM). Hotline: 01696-154400, Serial: 01958-33999.
  • Chamber 2: Alliance Colorectal & Biofeedback Center • 99/1 Khilji Scheme Road (Ring Road), Shyamoli, Dhaka-1207. Visiting Days: Sunday, Tuesday & Wednesday (3:00 PM – 5:00 PM). Hotline: 01729-966606.
  • Shaheed Suhrawardy Medical College Hospital: Inpatient surgical rounds and academic faculty service at Sher-E-Bangla Nagar, Dhaka.

You can secure an appointment serial through three convenient options:

  1. Phone Hotline: Call 01958-33999 (Panthapath chamber) or 01729-966606 (Shyamoli chamber).
  2. WhatsApp Desk: Send a message directly to 01672-586600 with patient name, age, and preferred day.
  3. Online Booking Form: Submit the booking form on this website to have our care coordinator confirm your serial time by return call.

Post-treatment prevention centers on maintaining soft, effortless bowel movements:

  • Hydration: Drink 2.5 to 3 liters of clean water daily.
  • Dietary Fiber: Consume adequate green leafy vegetables, unpeeled fruits, lentils, and isabgol (psyllium husk) when advised.
  • Bowel Hygiene: Never strain on the toilet or sit on the commode scrolling through mobile phones for extended periods.
  • Physical Activity: Daily 30-minute brisk walking stimulates healthy peristaltic bowel movement and prevents venous stasis.

Cosmetic outcome is one of the premier advantages of laparoscopic surgery. The tiny keyhole incisions (ranging between 5 mm to 10 mm) are closed with fine subcuticular absorbable sutures or medical tissue adhesive. Within several months, these marks typically fade into barely perceptible hairline lines that are naturally concealed by abdominal contours or the umbilicus.

DIRECT PATIENT CONSULTATION

Have a Specific Clinical Question or Concern?

Dr. Tanvir Ahmed and his clinical team are available to answer your queries, evaluate existing medical investigations, and guide you to the appropriate surgical solution.

WhatsApp Serial 01672-586600