Ek cheez jo I notice almost every day at my clinic — patients come in and the first question is: “Doctor, kya dawai se theek ho jayega?” And honestly, the answer depends. It depends on the grade, the symptoms, and how long you’ve been ignoring it. So instead of giving you a vague answer, let me actually walk you through all three options — dawai, laser, aur operation — and explain exactly when each one is needed.
I am Dr. Abdullah Iqbal, general surgeon and proctologist at Karachi Piles Clinic. I have been treating piles, fissure, and fistula for years. And I was the first surgeon in Pakistan to introduce laser treatment for piles back in 2022. So I think I am a fair person to explain this.
First — What Stage Is Your Bawaseer?
Before we talk about treatment, you need to understand that not all bawaseer is the same. There are four grades. And the grade decides everything — which treatment will work and which won’t. I wrote a detailed article on the difference between khooni and badi bawaseer if you want to understand this properly. But briefly:
- Grade 1–2 — Mild to moderate. Bleeding is main symptom. May or may not have prolapse.
- Grade 3–4 — Severe. Prolapse is present. Pain, lump outside, mucus discharge.
Okay. Now let’s go through each treatment option properly.
Option 1: Dawai (Medicines) — When Does It Work?
Medicines are the first step. And in my experience, they work well — but only for early stage bawaseer. Grade 1, sometimes Grade 2. If you have light bleeding, some itching, mild swelling after passing stool — medicines and a few lifestyle changes can genuinely bring relief.
Dawai ka kaam yeh nahi ke woh bawaseer ko hamesha ke liye khatam kar de. Medicines mainly control symptoms — bleeding, swelling, discomfort. They don’t remove the actual hemorrhoid tissue. So if you stop medicines without fixing your diet and lifestyle, the problem comes back. I have seen this pattern many times.
Commonly used medicines include:
- Daflon tablets — improves blood vessel tone, reduces swelling. Most commonly prescribed.
- Topical creams (like Xylocaine-based or Hedesa) — reduce local pain and burning.
- Stool softeners — very important. Hard stools are the enemy.
- Transamine capsules — for active or heavier bleeding.
Also — diet changes are not optional, they are part of the treatment. More fiber, more water. What you eat has direct impact on your symptoms. I always tell my patients to read about foods to avoid with piles because many people undo their own treatment by eating the wrong things.
Aur sitz bath — warm water soaking twice a day — yeh bhi medicine jaisi kaam karta hai. Simple lekin effective.
Option 2: Laser Treatment — My Preferred Choice for Most Patients
Laser treatment is what I use most at Karachi Piles Clinic. And I won’t pretend to be neutral here — I think laser is genuinely better than traditional surgery for most patients with Grade 2 and 3 hemorrhoids. Let me explain why.
In laser treatment, a thin laser fiber is inserted into the hemorrhoid. The laser energy shrinks the blood vessels and the swollen tissue from inside. No cutting. No big wound. The procedure itself takes about 20–30 minutes and most patients go home the same day.
In my experience, patients are back to normal activity within 3–5 days. Compare that to traditional surgery where recovery can take 2–4 weeks with significant pain. That’s a real difference for someone living a normal working life in Karachi.
Kya aapko bhi 2-3 hafte bed pe rehna afford hai? Most people can’t. Laser allows them to get treated and return to routine quickly.
You can read the full details of how we do it at our clinic: laser treatment for piles in Karachi.
But — and this is important — laser is not for everyone. Some patients with very large external hemorrhoids, or Grade 4 with significant tissue prolapse, still need open surgery. I always assess each patient individually. There is no one-size-fits-all in surgery.
Option 3: Operation (Hemorrhoidectomy) — When Is It Necessary?
Traditional surgery — hemorrhoidectomy — is the oldest and most definitive treatment for piles. When hemorrhoids are very large, severely prolapsed, or when laser isn’t enough, surgery is the right answer. No point avoiding it in those cases.
The procedure is done under anesthesia. The hemorrhoid tissue is surgically removed. Recovery is longer — typically 2 to 4 weeks — and the post-operative pain is more compared to laser. But for Grade 4 cases, it is the most reliable long-term solution.
Also, band ligation is another non-surgical option I use for Grade 1–2 cases — a rubber band is placed at the base of the hemorrhoid to cut off blood supply. Simple clinic procedure. You can read more about it here: band ligation treatment in Karachi.
Dawai vs Laser vs Operation — Direct Comparison
Let me put it all in one place so you can compare properly:
| Factor | Dawai (Medicines) | Laser Treatment | Operation (Surgery) |
|---|---|---|---|
| Best for | Grade 1–2 | Grade 2–3 | Grade 3–4 (large/severe) |
| Recovery time | Ongoing (lifestyle change) | 3–5 days | 2–4 weeks |
| Pain level | Minimal | Mild | Moderate to significant |
| Hospital stay | No | Same day / outpatient | 1–2 days usually |
| Permanent solution? | No (symptom control only) | Yes, in most cases | Yes |
| Risk of recurrence | High if lifestyle not changed | Low with diet changes | Low |
| Cost (relative) | Low | Medium | Medium to high |
My Honest Recommendation
In my opinion — if you are at Grade 1 or early Grade 2, start with proper medicines, diet correction, and sitz bath. Give it 3–4 weeks sincerely. Many patients improve significantly at this stage without needing any procedure.
If you are at Grade 2 with bleeding that keeps coming back, or Grade 3 — laser is the best option. Fast recovery, less pain, very effective.
Grade 4 or very large hemorrhoids — surgery may be needed. And that’s fine. Don’t be afraid of it. A well-done hemorrhoidectomy gives permanent relief.
One thing I always remind patients — whatever treatment you choose, piles can come back if you don’t fix the underlying habits. I have a full article on this: can piles come back after surgery. Please read it.
Frequently Asked Questions
Q: Kya bawaseer dawai se hamesha ke liye theek ho sakti hai?
Not always. Medicines control symptoms but don’t remove the hemorrhoid tissue. For Grade 1, with proper lifestyle changes, yes — long-term relief is possible. But for Grade 2 and above, medicines alone are usually not enough for permanent results.
Q: Laser treatment kitne time mein theek karta hai?
Most patients return to normal activity within 3–5 days. The procedure itself is 20–30 minutes. No hospital admission needed in most cases.
Q: Operation ke baad kitna dard hota hai?
Traditional hemorrhoidectomy has more post-operative pain compared to laser — usually managed with pain medications for 1–2 weeks. But the pain is temporary and the results are permanent.
Q: Karachi mein laser piles treatment kahan milti hai?
At Karachi Piles Clinic, we offer laser treatment for piles, fissure, and fistula. I personally perform all procedures. You can check the complete piles treatment options available at our clinic.
Q: Ilaj ke baad kya khayal rakhna chahiye?
After any treatment — medicine, laser, or surgery — diet and lifestyle changes are mandatory. High fiber food, plenty of water, avoid straining. Also check post-treatment care after laser surgery for detailed guidance.
Q: Mujhe kaise pata chalega ke mujhe kaun sa ilaj chahiye?
Honestly — only a proper clinical examination can tell. Don’t decide on your own based on what you read online. Come in, get examined, and then we decide together. That’s the right approach.
If you are in Karachi and want a proper evaluation, visit Karachi Piles Clinic. I see patients personally and examine each case before recommending anything. No rush, no pressure.
→ Book an appointment with Dr. Abdullah Iqbal
Written by Dr. Abdullah Iqbal – MBBS, FCPS (Surgery). General Surgeon and Laser Proctologist. Karachi Piles Clinic, Karachi, Pakistan.
