⚡ Adaptive Diagnosis Tool
Find Your Treatment
Answer a few questions and get a personalised recommendation — Medical, Laser, or Surgical — based on your symptoms.
Adapts to your answers
Clinically designed
Under 2 minutes
Guidance only, not a diagnosis. A confirmed diagnosis requires clinical examination. Any rectal bleeding must always be evaluated by a doctor.
Enter your details to begin
Phase 1 — Screening · Q1 of 5
What is your main complaint right now?
Choose the one that bothers you the most.
Severe sharp or burning pain when passing stoolLike a knife cut — pain during and after going to the toilet
Bleeding from the back passage without much painBright red blood on tissue or dripping into the pan
A lump, swelling, or something coming out near the anusMay or may not be painful
Pus, discharge or a wound near the back passageYellowish or foul-smelling fluid leaking from a hole
A very painful, hot, swollen lump near the anusThrobbing, tender — appeared suddenly over the last few days
Phase 1 — Screening · Q2 of 5
How would you describe any bleeding?
No bleeding at all
Bright red blood with severe painBleeding and sharp pain happen together
Bright red blood, painless or mild discomfortDripping or streaks — common with hemorrhoids
Blood mixed with pus or foul-smelling discharge
Phase 1 — Screening · Q3 of 5
How would you best describe your pain?
Sharp cutting or burning pain during and after stoolLasts minutes to hours after going to the toilet
Constant throbbing or aching near the anusDoes not go away — worse when sitting, tender to touch
Pressure, heaviness or fullness around the anusFeeling of something there, worse after long sitting
Dull ache or discomfort near a wound or opening
No significant pain
Phase 1 — Screening · Q4 of 5
Do you have any discharge or fluid near the back passage?
No discharge at all
Sticky mucus or just a wet feelingCommon with prolapsed hemorrhoids
Yellow, white or foul-smelling pusStrong indicator of fistula or abscess
Pus from a hole that keeps coming backPersistent leaking from a tunnel near the anus
Phase 1 — Screening · Q5 of 5
Is there any visible swelling or skin change near the anus?
Nothing visible outside
Soft swelling or lump that comes and goesAppears when straining, may go back on its own
Hot, red, very tender swellingCame on suddenly — very painful to touch
A small hole or opening in the skin near the anus
A small skin tag or tiny lump at the anal opening
Phase 2 — Confirming · Q1 of 3
How long have these symptoms been going on?
Less than 2 weeks — very recent
2 to 6 weeks
More than 6 weeksKeeps coming back or never fully resolved
Several months or longer
Phase 2 — Confirming · Q2 of 3
Have you tried any treatment for this condition?
No — nothing tried yet
Creams or medicines — helped partially
Creams or medicines — no improvement or getting worse
Had surgery or a procedure before — problem came back
Phase 2 — Confirming · Q3 of 3
How are your bowel habits?
Constipated — hard stools, straining, causes pain
Constipated — hard stools with swelling or bleeding
Normal — soft regular stools
Loose or runny stools, or alternating
Clarifying Question
Have you ever had a painful boil or abscess near the anus?
No, never
Yes, once — drained and seemed to heal
Yes — keeps coming back in the same spot
There is an open hole leaking pus near the anus
Clarifying Question
If you have a lump — which best describes it?
If there is no lump, select the last option.
Soft, goes back inside when pushedTypical prolapsed hemorrhoid
Always outside — cannot be pushed back in
Small flat tag of skin — not really a lump
No lump
Clarifying Question
Do you have any of these general symptoms?
Fever, chills, or feeling generally unwellSuggests active infection
Tiredness or dizziness, possibly from blood loss
None of the above — feeling generally well
Phase 3 — Severity · Q1
When you pass stool, does anything come out of the anus?
This determines the grade of hemorrhoids.
No — nothing comes outInternal swelling only — Grade 1
Yes, but goes back in on its ownSpontaneous reduction — Grade 2
Comes out and I push it back in manuallyManual reduction needed — Grade 3
Always outside — cannot be pushed backPermanently prolapsed — Grade 4
Phase 3 — Severity · Q2
Do you have any external skin tags around the anus?
Skin tags alongside hemorrhoids may need additional treatment.
No skin tags
Yes — one or more skin tags
Not sure
Phase 3 — Severity · Q1
How long does the pain last after passing stool?
A few minutes — settles quickly
Up to 1–2 hours
Several hours or most of the day
Almost constant pain — not just after stool
Phase 3 — Severity · Q1
Which best describes the opening or discharge near the anus?
One small opening that leaks occasionally
Multiple openings or a very deep / high track
Had treatment before but it came back
Not sure — just know there is discharge
👤 Your Details
First, tell us a little about yourself
Enter your details below so we can personalise your results and connect you with a specialist near you.
Please enter your name
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Analysing your answers…
Medical Treatment
Hemorrhoids Grade 1–2
Your symptoms are most consistent with early-stage hemorrhoids. Grade 1–2 hemorrhoids respond well to dietary changes and medication. A brief clinical examination will confirm the grade and best treatment path.
Recommended Treatment
- High-fibre diet — fruits, vegetables, Ispaghol husk daily
- 8–10 glasses of water daily to soften stools
- Sitz bath (warm water, 15 min) twice daily
- Topical haemorrhoidal cream (Proctosedyl or Ultraproct)
- If bleeding continues frequently, laser treatment is the next step
Laser Procedure
Hemorrhoids Grade 1–2 with Frequent Bleeding
Frequent bleeding at any grade can lead to anaemia over time. Laser hemorrhoidoplasty provides a definitive, minimally invasive solution with very quick recovery.
Recommended Treatment
- Laser Hemorrhoidoplasty (LHP) — diode laser, no cuts, no stitches
- Day-care procedure, 20–30 minutes
- Resume normal activity in 1–2 days
- Stops frequent bleeding immediately and definitively
Laser Procedure
Hemorrhoids Grade 3–4
Advanced prolapsing hemorrhoids require definitive treatment. Laser hemorrhoidoplasty is the modern gold standard — significantly less painful than conventional surgery with a much faster recovery.
Recommended Treatment
- Laser Hemorrhoidoplasty (LHP) + Hemorrhoidopexy
- No large wounds — same-day procedure, home same day
- Return to work in 2–3 days
- Far less post-operative pain than conventional haemorrhoidectomy
Laser + Harmonic Scalpel
Hemorrhoids Grade 3–4 with Skin Tags
Your symptoms suggest advanced hemorrhoids with external skin tags. Laser treats the internal component while the Harmonic scalpel precisely removes the tags — both done in one session.
Recommended Treatment
- LHP Laser for internal hemorrhoidal tissue
- Harmonic scalpel excision of skin tags
- One anaesthesia, one recovery — best outcome
- Harmonic seals and cuts simultaneously — minimal bleeding
Medical Treatment
Acute Anal Fissure
Your symptoms suggest a fresh fissure with good healing potential. Most acute fissures heal within 4–6 weeks with the right medication. If it does not heal, laser treatment is the next step.
Recommended Treatment
- GTN 0.2% or Diltiazem 2% ointment twice daily
- Topical anaesthetic cream before passing stool
- High-fibre diet + Ispaghol husk — soft stools are essential
- Sitz bath (warm water, 15 min) morning and after every stool
- Reassess in 4–6 weeks — if not healed, laser is next
Laser Procedure
Chronic Anal Fissure
A chronic fissure has a sphincter in permanent spasm which prevents healing. Medication alone cannot break this cycle. Laser sphincterotomy with Botox is highly effective with over 95% success rate.
Recommended Treatment
- Botox injection into the internal anal sphincter
- Laser-assisted Lateral Internal Sphincterotomy (LIS)
- Day-care procedure — home within hours, no stitches
- Pain relief often felt within 24–48 hours
FiLaC Laser
Anal Fistula (Bhagandar)
Your symptoms are consistent with an anal fistula. FiLaC is the gold standard laser technique — it seals the tract without cutting the sphincter, preserving continence completely.
Recommended Treatment
- FiLaC — Fistula-tract Laser Closure
- No cutting of sphincter muscle — continence fully preserved
- Day-care, minimal post-op pain, back to work in 2–4 days
- 70–85% success rate — best of any sphincter-preserving technique
FiLaC + LIFT
Complex Anal Fistula
Your symptoms suggest a complex or high fistula. The combination of FiLaC laser and LIFT procedure addresses both the tract and internal opening, giving the highest success rate while still preserving the sphincter.
Recommended Treatment
- FiLaC Laser seals the fistula tract from inside
- LIFT: internal opening ligated in the intersphincteric plane
- 100% sphincter-preserving — zero incontinence risk
- MRI fistulogram recommended before treatment
Urgent Assessment
Likely: Perianal Abscess
Your symptoms suggest an acute perianal abscess that needs urgent drainage. An abscess will not resolve on its own — please seek assessment today. Go to emergency if you have fever or spreading swelling.
Recommended Treatment
- Incision & Drainage (I&D) — urgent, do not delay
- 15–20 minute procedure — immediate pain relief
- Antibiotics alone do NOT treat abscess — drainage is essential
- After healing, investigate for underlying fistula (30–50% of cases)
What Is This Treatment Finder Tool?
This piles self-diagnosis tool is designed to help patients in Karachi and across Pakistan identify whether their symptoms are consistent with hemorrhoids (piles / bawaseer), an anal fissure (shigaaf), an anal fistula (bhagandar), or a perianal abscess. The tool uses an adaptive 3-phase question system — screening, confirmation, and severity — to generate a personalised treatment recommendation in under 2 minutes.
Who Should Use This Tool?
You should use this tool if you are experiencing any of the following: pain when passing stool, rectal bleeding, a lump or swelling near the anus, persistent itching or burning, pus or discharge from near the back passage, or a swelling that keeps coming back in the same spot. These are the most common symptoms of the four main anorectal conditions treated at Karachi Piles Clinic.
This tool is especially helpful if you are unsure whether your problem is piles, fissure, or fistula — a very common situation. Many patients confuse these conditions because their symptoms overlap. The adaptive questionnaire separates them based on your specific pattern of symptoms.
Understanding Your Result
The tool produces one of nine possible results across four conditions:
- Hemorrhoids Grade 1–2 (Medical): Diet, sitz bath, and topical creams. No procedure needed at this stage.
- Hemorrhoids Grade 1–2 with Frequent Bleeding: Laser Hemorrhoidoplasty (LHP) — a 20-minute day-care laser procedure.
- Hemorrhoids Grade 3–4: Laser LHP + Hemorrhoidopexy. Advanced prolapse treated definitively with laser.
- Hemorrhoids Grade 3–4 with Skin Tags: Laser LHP combined with Harmonic Scalpel for skin tag removal in one session.
- Acute Anal Fissure: GTN or Diltiazem ointment, stool softeners, sitz bath. Most heal within 6 weeks.
- Chronic Anal Fissure: Botox injection + Laser Lateral Internal Sphincterotomy (LIS). Over 95% success rate.
- Anal Fistula (Simple): FiLaC — Fistula-tract Laser Closure. Sphincter-preserving, same-day procedure.
- Anal Fistula (Complex): FiLaC combined with LIFT procedure for high or recurrent fistulas.
- Perianal Abscess: Urgent Incision and Drainage (I&D). An abscess will not resolve without surgical drainage.
Important Disclaimer
This tool provides indicative guidance only. It is not a substitute for a clinical examination by a qualified proctologist. A confirmed diagnosis of piles, fissure, fistula, or abscess requires physical examination and, in some cases, imaging. Any rectal bleeding must always be evaluated by a doctor — do not ignore it. The results generated by this tool are a starting point for conversation with your specialist, not a definitive medical diagnosis.
After Your Result — What Next?
Once you have your result, use our Find a Specialist directory to locate a verified laser proctology surgeon in your city — available across Karachi, Lahore, Islamabad, Rawalpindi, Faisalabad, Multan, Peshawar and more. You can also browse our Find a Hospital page to identify a facility near you equipped for laser proctology procedures.