Haemorrhoids (Piles) are swollen blood vessels in the back passage. One in three people experience haemorrhoidal symptoms at some time. The most usual cause is straining to open the bowels, and piles are more common during or after pregnancy. They can cause rectal bleeding and discomfort and many protrude outside the anal canal. There are a number of different treatment options.

Injections for Piles

This involves injecting a small amount of a chemical called phenol near the haemorrhoid causing it to shrivel up. This treatment will usually take 4-6 weeks to be effective, so you should not expect immediate relief. Many people require more than one injection, but again you should be able to get back to your normal life almost immediately.

'Banding' of Piles

This involves using a small instrument to put a tight elastic band over the haemorrhoid. The band cuts off the blood supply so that the haemorrhoid should drop off within 3-7 days. You should be able to get back to your normal life straight away. You may be seen again in 6-12 weeks to check that the banding has been successful. Sometimes the banding needs to be repeated, but this is generally a superior treatment compared to injections.

Haemorrhoidectomy

Surgical removal is the best method for the permanent removal of haemorrhoids. This becomes necessary when simpler treatments such as banding or injections fail, and where there is a degree of prolapse or protrusion. This may be performed using general anaesthetic or a spinal block and usually requires at least an overnight stay, and often longer. Various methods are available for surgical removal including LigaSure™.

Stapled Haemorrhoidectomy ('PPH' - Procedure for Prolapse and Haemorrhoids)

PPH is a surgical technique which enables suitable patients to recover from haemorrhoid surgery faster and with less pain when compared to conventional haemorrhoidectomy. Using a special stapling device, PPH 'lifts up' or repositions the anal canal tissue, and reduces blood flow to the internal haemorrhoids. These haemorrhoids, then, typically shrink within a few weeks after the procedure. The PPH procedure results in less pain than traditional haemorrhoidectomy because it is performed above the "pain" line inside the anal canal, whereas traditional haemorrhoidectomy procedures are performed below this line. Mr Tsavellas will discuss the suitability of this operation with you at the time of your consultation.

THD [Transanal Haemorrhoidal De-arterialisation] or HALO [Haemorrhoidal Artery Ligation]

Transanal haemorrhoidal dearterialisation (THD) or haemorrhoidal artery ligation (HALO) is an operation to reduce the blood flow to your haemorrhoids. This procedure can be carried out either under general or spinal (local) anaesthetic and involves inserting an Doppler ultrasound probe into the anus. This probe allows accurate localisation of the arteries supplying blood to each haemorrhoid. Each artery is then stitched to block the blood supply to the haemorrhoid, causing it to shrink over the following days and weeks. 

The National Institute for Health and Care Excellence (NICE) recommends this treatment as an effective alternative to an open haemorrhoidectomy or stapled haemorrhoidectomy. The procedure causes less pain than traditional haemorrhoidectomy and patients report a high level of satisfaction. Most patients are able to return to their normal activities quickly. Mr Tsavellas will discuss the suitability of this procedure with you at your outpatient consultation.

Learn more about the THD procedure here.

Prevention

Increase the amount of fibre and water in your diet. Fibre is not completely digested and absorbed by the body, so it provides bulk to the stools. This helps the movement of waste through the bowel resulting in stools that are easier to pass.

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