Signs This May Be Worth Discussing
- Bleeding during or after passing stool, even if it seems minor
- A lump, swelling or prolapse around the anus
- Discomfort, itching or a feeling of incomplete emptying
- You would prefer a treatment that avoids a lengthy, painful recovery
- You want to return to work and normal activity as quickly as possible
Why Piles Develop
- Chronic constipation and repeated straining
- A low fibre diet and inadequate hydration
- Prolonged sitting or a sedentary occupation
- Pregnancy and the added pressure it places on pelvic veins
- A family history of piles
- Increasing age, as supporting tissue naturally weakens over time
Treatment addresses the piles that have already developed; managing these lifestyle factors afterwards is what helps keep them from coming back.
Understanding the Four Grades of Piles
Grade I: small internal piles that do not prolapse and are often found incidentally during examination.
Grade II: piles that prolapse with straining but return on their own afterwards.
Grade III: piles that prolapse and need to be pushed back in manually.
Grade IV: piles that remain permanently prolapsed and cannot be pushed back in.
Watch: The Four Grades of Piles Explained
In this short video, Dr. Jignesh Gandhi walks through each grade of piles, the symptoms you might notice, and when radiofrequency treatment such as Rafaelo may be suitable.
Should You Be Worried?
Piles are extremely common and rarely serious, but bleeding should never be assumed to be from piles without an examination, since other conditions can cause similar symptoms. Left untreated, piles tend to worsen gradually rather than resolve on their own, so it is worth having them properly assessed rather than managing symptoms indefinitely.
Is Rafaelo Right for You?
Rafaelo works best for internal piles of an early to moderate grade, typically Grade I to III, where the tissue can be treated effectively with radiofrequency energy alone. Very advanced Grade IV piles, or piles with certain complications, are usually better suited to conventional surgery.
Dr. Gandhi assesses each case individually and will recommend the most appropriate option, Rafaelo or otherwise, for your specific grade and symptoms.
How It's Assessed
1. Clinical history and discussion of your symptoms, including bleeding pattern and duration
2. Physical examination to identify and grade the piles present
3. Proctoscopy, a brief internal examination to view the affected tissue directly
4. Treatment planning, confirming whether Rafaelo or an alternative approach is most suitable
How the Rafaelo Procedure Works
- Radiofrequency energy is delivered directly into the haemorrhoidal tissue through a fine probe, causing it to shrink over the following weeks.
- No cutting or stitches are involved, which is the main reason recovery is so much faster than conventional surgery.
- Local or light sedation is generally sufficient, and general anaesthesia is not usually required.
- Performed as a day case, with most patients going home within a few hours of the procedure.
- Return to light activity is typically possible within a day or two.
Recovery and Aftercare
Most patients go home the same day and experience only mild discomfort, managed with simple pain relief. Light activity can usually resume within a day or two, with a full return to normal routine, including most forms of exercise, within about a week, though this varies by individual. You will be given specific guidance on diet, hydration and wound care to support healing and reduce the chance of recurrence.
Contact the clinic promptly if you experience heavy bleeding, worsening pain, fever, or any symptom that concerns you during recovery.
Why Choose Dr. Jignesh Gandhi
- Pioneering experience: among the first surgeons in India to introduce radiofrequency treatment for piles, and a leading practitioner of the Rafaelo technique today.
- Academic and clinical depth: 27 years associated with a teaching institution, alongside an active surgical practice at Nanavati Max Hospital.
- A full range of options: from Rafaelo to conventional surgery, so the technique recommended is the one that suits your specific case, not a one-size-fits-all approach.
- Established reputation in Mumbai: part of a high-volume robotic and minimally invasive surgical practice, with patients travelling from across Mumbai, Gujarat and Goa.
Frequently Asked Questions
Most patients experience little to no pain, since no tissue is cut or removed. Some mild discomfort in the first day or two is normal and manageable with simple pain relief.
No. Rafaelo is usually performed under local or light sedation as a day case, and most patients go home the same day.
It works best for Grade I to III internal piles. Very advanced Grade IV piles or certain complications may be better suited to conventional surgery, which is assessed at your consultation.
Both are minimally invasive, but Rafaelo uses radiofrequency energy rather than laser energy to shrink the tissue. Dr. Gandhi can explain which approach is most appropriate for your specific case during consultation.
Many patients return to desk-based work within a day or two. Physically demanding work may need a slightly longer break, which will be discussed based on your occupation and recovery.
You can book a consultation by phone or through the contact form on this website. See the Contact Us page for details.
Book Your Piles Treatment Consultation in Mumbai
There is no need to live with piles or delay treatment out of embarrassment. Dr. Jignesh Gandhi offers Rafaelo treatment at Nanavati Max Hospital, Mumbai.