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Best Doctors For pilonidal-sinus
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    Dr. Falguni Rakesh Verma (klJ7Egw4gu)

    Dr. Falguni Rakesh Verma

    MBBS, MS - General Surgery
    27 Yrs.Exp.

    4.5/5

    27 + Years

    Mumbai

    General Surgeon

    Laparoscopic Surgeon

    Proctologist

    Call Us
    6366-448-340
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    Dr. Sanjeev Gupta (zunvPXA464)

    Dr. Sanjeev Gupta

    MBBS, MS- General Surgeon
    25 Yrs.Exp.

    4.9/5

    25 + Years

    Delhi

    General Surgeon

    Laparoscopic Surgeon

    Proctologist

    Call Us
    6366-448-340
  • online dot green
    Dr. Milind Joshi (g3GJCwdAAB)

    Dr. Milind Joshi

    MBBS, MS - General Surgery
    23 Yrs.Exp.

    4.7/5

    23 + Years

    Pune

    General Surgeon

    Proctologist

    Laparoscopic Surgeon

    Call Us
    6366-448-340
  • About Pilonidal Sinus
    Pilonidal Sinus Form
    Types of Disease, Causes and Symptoms
    Diagnosis
    Risks & Complications
    Consult With Doctor
    Treatment Options & Cost
    Facts and Statistics Around Pilonidal Sinus

    What is a Pilonidal Sinus?

    A Pilonidal sinus is a small tunnel or hole in the skin that gets filled with pus, fluid, and debris causing the formation of a cyst or abscess. A pilonidal sinus occurs in the cleft at the top of the buttocks. Along with fluid and debris, a pilonidal sinus is often filled with hair and dirt. The condition can lead to severe pain and the infection is likely to spread to the nearby body parts if not treated on time. When infected, a pilonidal sinus may ooze pus and infected blood and emit a foul smell.

    How does a pilonidal sinus form?

    Pilonidal sinus is basically a skin problem. When there is too much friction and pressure in the anal area, the hair between the buttocks gets pushed inward. This may either be caused by the hairs growing around the buttocks or due to the loose hair shed from the buttocks area that gathers around the cleft and gets into the pilonidal sinus.

    Types of Disease, Causes and Symptoms - Pilonidal Sinus

    Types of Disease:

    • Acute pilonidal sinus
    • Chronic pilonidal sinus

    Causes of Pilonidal Sinus:

    • Changing hormones
    • Friction from the clothes
    • Hair growth in the buttocks
    • Sitting for long hours

    Symptoms of Pilonidal Sinus:

    • Irritation in the skin
    • Small dimple
    • Large painful mass (inflammation or abscess)
    • Clear, cloudy, or bloody fluid drainage from the affected area
    • If infected, the area becomes red and tender and the drainage (pus) smells foul
    • Fever and nausea

    Diagnosis of Pilonidal Sinus

    Tests:

    If it is a case of a prominent and severe pilonidal sinus, the anorectal specialist will be able to diagnose it just through physical examination. In case the doctor cannot evaluate the condition just by looking at the pilonidal cyst, the following tests are recommended for diagnosis. Common tests which are done on pilonidal sinus piles are:

    1. Digital examination – In this test, the proctologist inserts a gloved, lubricated finger into the rectum to check if there are any kind of abnormal growths. The test also confirms the depth of the tunnel and how far the condition has grown.

    2. Visual inspection – In visual inspection, the pilonidal sinus specialist might examine the lower rectum using a proctoscope, an anoscope, or a sigmoidoscope. Using any of these devices, the doctor will carefully examine the lining of your anal tissues to check the severity and growth of the tissues.

    3. Lab swab test – In rare conditions, the proctologist might recommend the patient undergo a lab swab test. During the test, the doctor takes tissues from the affected area and sends them for a biopsy. The test is done to check if the tissues have grown cancerous to determine the best line of treatment where the pilonidal sinus grows severe.

    Self- Diagnosis:

    Self-diagnosis of pilonidal sinus is not very difficult if you are well aware of the symptoms. You can check for the prevalence of any of the pilonidal sinus symptoms and can evaluate yourself if you are suffering from the same. It is highly likely that your symptoms will always begin with pain and discomfort while sitting. A person with an infected pilonidal sinus may also experience pain, redness, and swelling in the affected area. There might also be a small opening (sinus tract) from where blood drainage might occur. Pay attention to your anal area react each time you make a bowel movement. Check for blood in your stool. But diagnosing the anal area and checking for the symptoms yourself could be tough, which is why it is advisable that you check your condition with a trained and experienced proctologist.

    Diagnosis by Doctor:

    Most proctologists or anorectal surgeons diagnose piles through physical examination alone. Once you visit the doctor’s clinic, you are likely to be asked a few questions, including:

    • Do you have a family history of pilonidal sinus?
    • When did you start having the symptoms?
    • Has the cyst changed in appearance?
    • Is it draining any fluid?
    • What are your dietary and lifestyle habits?
    • What is your fitness regime like?
    • Do you pass blood with your stool?
    • Do you feel pain in your buttocks or anal area while sitting?

    The proctologist may also do a digital rectal examination to diagnose the condition of your pilonidal sinus. The pilonidal sinus specialist may also suggest tests like colonoscopy, sigmoidoscopy, and anoscopy to check for the presence of any gastrointestinal disease. In all these tests, the doctor would insert a small camera to check for any abnormalities in the anus, rectum, and colon. If the doctor feels that your condition of pilonidal sinus is not very severe, the doctor may recommend medicines for the time being. But if the condition is severe, the doctor might recommend you undergo advanced surgery for pilonidal sinus.

     

    Risks & Complications of Pilonidal Sinus

    During the Surgery:

    Pilonidal sinus surgery is not complex but one needs to make sure that he or she in the right hands. Undergoing the surgery at the hands of a trained doctor cuts down the chances of your risks significantly. But, like any other surgical treatment, the success or risks associated with pilonidal sinus treatment are also highly dependent upon the severity of the condition and the surgeon’s experience. Although not very common, a patient may suffer from any of the following conditions during or after the surgical treatment of pilonidal sinus.

    • Trauma and bleeding – If the surgery is not efficiently performed, there is a chance that the anal tissues might be injured. Trauma and injury to the injuries may lead to bleeding. The chances of bleeding during pilonidal sinus surgery is higher in the case of open surgery. The risk of injury entirely depends on the experience of the surgeon who performs the surgery. Additionally, the complication may also get severe or lower depending upon the condition of the pilonidal sinus.
    • Infection – Infections can develop at any point during pilonidal sinus surgery. The chances of the surgical site getting infected are higher in case of open surgery or in cases where the patient does not allow the site to heal properly.
    • Reaction to anesthesia – Several patients report experiencing side effects of anesthesia. Due to the reaction, the patient might feel drowsy and nauseated for a longer time than usual. This is not a very complex risk. But if the effects of the anesthesia remain for longer than usual, the patient should consult with the doctor.
    • Squamous cell carcinoma – A form of skin cancer that occurs due to uncontrolled growth of the squamous cells. Although a very rare complication, people have reported suffering from the complication.

    If Left Untreated:

    Pilonidal sinus surgery is not complex but one needs to make sure that he or she in the right hands. Undergoing the surgery at the hands of a trained doctor cuts down the chances of your risks significantly. But, like any other surgical treatment, the success or risks associated with pilonidal sinus treatment are also highly dependent upon the severity of the condition and the surgeon’s experience. Although not very common, a patient may suffer from any of the following conditions during or after the surgical treatment of pilonidal sinus.

    • Trauma and bleeding – If the surgery is not efficiently performed, there is a chance that the anal tissues might be injured. Trauma and injury to the injuries may lead to bleeding. The chances of bleeding during pilonidal sinus surgery is higher in the case of open surgery. The risk of injury entirely depends on the experience of the surgeon who performs the surgery. Additionally, the complication may also get severe or lower depending upon the condition of the pilonidal sinus.
    • Infection – Infections can develop at any point during pilonidal sinus surgery. The chances of the surgical site getting infected are higher in case of open surgery or in cases where the patient does not allow the site to heal properly.
    • Reaction to anesthesia – Several patients report experiencing side effects of anesthesia. Due to the reaction, the patient might feel drowsy and nauseated for a longer time than usual. This is not a very complex risk. But if the effects of the anesthesia remain for longer than usual, the patient should consult with the doctor.
    • Squamous cell carcinoma – A form of skin cancer that occurs due to uncontrolled growth of the squamous cells. Although a very rare complication, people have reported suffering from the complication.

    When To Consult A Doctor For Pilonidal Sinus?

    Knowing when to seek professional help for any health condition is extremely important for the right treatment of any anorectal disease including pilonidal sinus. Getting medical help at the right time can help you avoid unnecessary complications. Schedule an appointment with a reliable proctologist if the sinus tract becomes suddenly painful or swollen. This could be indicative of infection or rupture in the pilonidal sinus.

    If you experience any of the following complications or conditions, it is time you check with an anorectal surgeon.

    • You have excruciating pain and discomfort in your anal area or while making a bowel movement.
    • The foul and smelly stool appears when the infection spreads.
    • No amount of medications and home remedies are able to provide you relief from your symptoms.
    • If you feel dizzy and uncomfortable due to the constant discharge of pus and debris.

    Treatment Options & Cost of Pilonidal Sinus Surgery

    Non-surgical treatment for pilonidal sinus:

    If there is no sign of inflammation or infection, the first line of treatment that the doctor is likely to suggest is a broad-spectrum antibiotic. A broad-spectrum antibiotic can treat a wide range of bacterial infections. The ointments do not heal the sinus tract but will provide symptomatic relief from the infection and pain. Your doctor is likely to recommend a follow-up test and maintain proper hygiene of the anal area.

    Home remedies for pilonidal sinus

    Home remedies for pilonidal sinus are intended to provide temporary relief and not a permanent cure for the pain and swelling. Some of the common treatments for pilonidal sinus may include:

    • Sitz baths – Soaking the affected area in warm water for 15-20 minutes, 3-4 times every day can bring relief to the pain and cut down the chances of the pilonidal cyst from getting worse.
    • Vitamin supplements – Zinc and vitamin C supplements can quicken the healing process of the sinus tract. Using vitamin A can also help in repairing damaged tissues. However, one should always consult with an expert doctor for the right dose of supplements.
    • Tea tree oil – Applying tea tree oil to the cyst may help to soothe the cyst and fighting infection in the affected area. Tea tree oil has been relied on for ages now as a good treatment for any anorectal condition.
    • Castor oil – Castor oil is particularly helpful in reducing the swelling of the pilonidal cyst. It also helps to get rid of the infection that may be present within the cyst and hasten the healing process.
    • Baking soda – Baking soda helps manage the swelling and soothes the irritated skin. Applying baking soda with vinegar can fasten the healing process because of its antimicrobial properties.
    • Honey – Honey is a natural antiseptic with anti-inflammatory properties. That is why honey, paired with some cinnamon, is extremely helpful in reducing a Pilonidal Cyst.
    • Apple cider vinegar – The vinegar helps to maintain the pH level of the skin and helps to remove the toxins from the Pilonidal cyst.
    • Exercise – Regular exercise can improve blood flow to the affected area which can aid the healing process.

    Surgical treatments:

    1. Lancing – This treatment is done under the influence of local anesthesia. The procedure alleviates the painful symptoms of the abscess. Before proceeding with the treatment, the proctologist sedates the patient with anesthesia. The doctor then uses a scalpel to open the abscess and clean the dirt, blood, hair, and debris. Once the cleaning is done, the doctor would cover the wound with a sterile dressing and allow it to heal from inside.  The healing may need anywhere from 4-6 weeks. This treatment often offers effective results and most often the patient does not require any further treatment.
    2. Open surgery for pilonidal sinus- There are two common types of open surgery- incision and drainage, and pilonidal cystectomy.
    3. Incision and drainage- This type of open procedure when the cyst becomes infected. It is performed with local anesthesia to make the affected area numb. The surgeon makes an incision in the cyst to drain the infectious fluid and pus. Further, the doctor packs the hole with gauze and leaves it open to heal.  It can take up to 4-6 weeks to heal the cyst completely. And, the gauze should be changed at regular intervals.
    4. Pilonidal cystectomy- The surgical removal of the entire pilonidal cyst is called pilonidal cystectomy. The doctors used to perform this conventional procedure for a recurring cyst. It is also performed after administering general/regional anesthesia. The surgeon makes a cut to remove the affected skin along with underlying hair follicles, tissues, and dead cells. Based on the size of the cyst removed, the doctor may or may not pack the area with surgical gauze. In cases where the infection is severe, the doctor places a tube to drain the fluid from the cyst. The tube is only removed when the entire fluid has been collected from the cyst. This lessens the chances of recurrence.
    5. Laser pilonidal sinus treatment- During the procedure, the surgeon uses a high-intensity laser beam to close off the sinus. Also, the doctor ensures to remove the entire pit of the pilonidal sinus so that the infection does not recur. It is an easier and higher precision procedure to perform as compared to the earlier-mentioned types of open surgery. Furthermore, only one day of dressing is required as there are wounds left behind to heal. The laser energy also promotes the faster healing of the site of the surgery.  Thus, it takes a very short time to completely recover from laser surgery for the pilonidal sinus.

    Why Choose Pristyn Care for Pilonidal Sinus Surgery?

    • Pristyn Care is a certified Centre of Excellence for anorectal treatments for diseases like pilonidal sinus, fissure, piles, and anal fistula.
    • Pristyn Care houses some of the top anorectal surgeons in the country who have years of experience in delivering surgical treatment anal fissure – acute and chronic with a high success rate.
    • Pristyn Care is associated with some of the top hospitals across India that are equipped with state-of-the-art facilities required to perform advanced anorectal surgeries.
    • Proctologists/ General Surgeons working with Pristyn Care do a thorough consultation in the case of every patient to understand the health condition and then determine the treatment method that will work best.
    • To ease the commuting process for our patients, we also provide free cab facilities to bring you from home to the hospital and help you return back home after the surgery.
    • A free-of-cost follow-up is provided to the patients within the first seven days after the surgery.
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    FAQs Around Pilonidal Sinus

    How do I know I have Pilonidal Sinus?

    Some of the symptoms to look out for in Pilonidal Sinus are:

    • Formation of a small dimple-like structure
    • Large painful mass
    • Watery, purulent discharge from the pilonidal sinus
    • Pain while sitting or a little push due to tight clothing.

    Can pilonidal cyst or sinus be drained at home?

    You should not drain the cyst or the sinus at your own risk because it may increase the risk of infection in the affected area. If you do not have access to sterile materials, bacteria can enter the wound which can further cause infection. Hence it is better if you consult with an experienced proctologist and undergo the treatment from a pilonidal specialist only.

    Can pilonidal sinus be treated with antibiotics?

    No, antibiotics can only provide relief from the symptoms and not the condition at large. Antibiotics do not provide a permanent cure for any anorectal disease including pilonidal sinus. If you experience swelling, redness, and itching in the anal area, using antibiotics can provide you relief from these symptoms. But if you are looking to drain the pilonidal sinus tract and get permanent relief, you should rely on surgical treatment.

    How to avoid complications after pilonidal sinus laser surgery?

    If you go through with the laser procedure for pilonidal sinus treatment, the chances of encountering any problems or complications are negligible. Just make sure you take proper rest and follow all the postoperative instructions provided by your doctor and your recovery will be completely smooth.

    Is pilonidal sinus hereditary?

    The risk of developing pilonidal sinus can depend upon factors like the shape of the buttocks and the extent of hair growth. Since these factors are genetic and travel from one generation to another, it can be said that certain factors causing pilonidal sinus are hereditary.

    Can a pilonidal sinus heal on its own?

    In some cases, a pilonidal sinus can heal on its own. But then it can recur and cause other infections also. Hence, it is recommended to undergo laser surgeries that provide permanent relief and it is completely painless.

    Does a pilonidal sinus keep recurring?

    The most common reason for the recurrence of a pilonidal sinus is incomplete drainage of the cyst or the sinus tract. If the drainage of the cyst remains incomplete, the pilonidal sinus can recur in the near future. Later recurrence of the pilonidal sinus happens mainly due to tension and trauma in the midline cleft. In some other cases, the sinus reappears due to any infection that builds up and accumulates in the cleft area because the wound does not heal properly.

    Does pilonidal sinus surgery hurt?

    Pilonidal sinus is a comparatively less painful surgery than any other form of anorectal surgery. But there may be instances where the person might feel some pain. In that case, the doctor is likely to prescribe pain medications and ointments for quick relief. Once you get relief from the pain, you can consult with your anorectal surgeon and stop taking the medicines.

    What is the difference between a pilonidal cyst and a pilonidal sinus?

    A pilonidal cyst is a cyst filled with fluid or pus that forms near the natal cleft. On the other hand, a pilonidal sinus is a tunnel/channel that forms inside the natal cleft due to recurrent anaerobic infections in the region.

    Can pilonidal sinus cause cancer?

    In rare and severe cases, pilonidal sinus can increase the risk of a certain type of skin cancer called squamous skin carcinoma. Therefore, it is advisable to seek medical attention for the pilonidal sinus in time.