David Woodhead, a 35-year-old Chartered Surveyor from Huddersfield in West Yorkshire, had been troubled for eight years by pain, discomfort and bleeding from the rectum during and after using the toilet. This worrying symptom got progressively worse until eventually in 2010, David plucked up the courage to go and see his GP, who referred him for several investigations, including blood tests, a colonoscopy and an endoscopy. Sometimes, bleeding from the rectum can be an indication of a serious disease such as cancer, but to David’s great relief, the investigations ruled out anything really sinister. However, he was told that he had severe haemorrhoids (piles) and was anemic, possibly due to the bleeding they had caused for many years.
Piles are enlarged and swollen blood vessels in or around the back passage. Some of the vessels may burst and bleed. The condition is not usually very serious and often resolves within a few days. But in some people it can become chronic, causing recurrent bleeding, extreme discomfort and pain. Piles vary in size and can occur internally or externally - if they're internal they often go undetected until they bleed (the blood will usually be a shade of bright red). If they’re external, piles can be particularly uncomfortable as they become itchy and irritate the skin. Often, people compare the sensation of external piles to ‘sitting on a spike’.
David had private medical insurance, so his GP referred him for treatment at his local private hospital in Huddersfield. But despite undergoing two types of treatment – banding and injections - for his advanced haemorrhoids, David’s condition did not improve.
He says, “Having waited so long to do something about my condition, I was very disappointed that the treatments didn’t work. I decided to do my own research, and found an article in the Daily Mail and another one on the internet about a consultant surgeon, Mr Giordano, who could perform a pioneering treatment called THD for advanced haemorrhoids that were difficult to treat.”
Mr Pasquale Giordano is a Consultant General Surgeon with a private practice at Spire Roding Hospital in Essex. He says, “The conventional surgical technique for haemorrhoids involves cutting piles out from the sensitive skin of the back passage - it can be very painful, take a long time to heal and some people experience problems with bowel control afterwards.”
“But THD, or Transanal Haemorrhoidal Dearterialisation, is a newer technique that works by stitching up the arteries that feed the piles and stopping their blood supply” explains Mr Giordano.
"First, we use a miniature ultrasound device, like a short telescope, to locate all the arteries supplying the piles. This 'telescope' has a needle inside it which pops out and inserts a stitch (or two if necessary) into the artery supplying the pile."
"As soon as the blood flow is stopped, the pile will shrink and over the next few days and weeks should return to a normal size. In this way the piles are pulled back to their natural position, reducing the risk of them growing again. THD can be successfully performed on even the most advanced cases, those that would otherwise not be suitable for any other minimally invasive treatment. David was a suitable candidate for THD, even though his haemorrhoids were advanced and had not responded to other treatments.”
David says, “Although Mr Giordano was based at Spire Roding Hospital in Essex, 200 miles from where I lived, I decided that I wanted to see him. I was very anxious to do something about my haemorrhoids and reading about the THD operation offered me hope.”
At the end of January 2011, David and his wife made the long journey from West Yorkshire to Spire Roding in Essex to discuss his condition with Mr Giordano. David says, “Mr Giordano examined me and took my medical history. He said he was confident that the THD procedure would stop the bleeding and cure my anemia. He explained the procedure thoroughly to me, and said what would happen before, during and after the operation.”
Just 10 days after his first consultation, David had the THD operation at Spire Roding. The procedure went smoothly. David says, “After the op, I felt a bit groggy, but had surprisingly little pain. I stayed overnight and my wife drove me home. I followed the instructions given to me by Mr Giordano and the hospital staff, to take pain killers for a couple of days.”
“I was back at work within four days of having the operation, which I thought was amazing. A few weeks later, I attended a follow-up appointment with Mr Giordano. He examined me and confirmed that everything had healed well.”
Mr Giordano says, "As David found out, the THD operation involves less pain - because the blood supply is cut off at the root of the pile and the stitches are placed in the lower rectum (above the back passage) where there are virtually no pain nerves. There are no open wounds to heal because it's all done internally.
This means that patients like David tend to recover swiftly and return to work, often within 24 to 48 hours. Research suggests that with THD patients, about 90% have a complete resolution of their symptoms.”
Nearly a year down the line, David says, “I feel perfect. I no longer bleed when I go to the toilet, and my anemia has been cured. I feel confident, fitter and much more able to do physical things, including proper exercise and playing with my daughters! I take Fybrogel every day as a precaution.”
David has some wise words for people who are suffering from pain and discomfort caused by haemorrhoids.
“Don’t suffer in silence like I did… get the problem dealt with early on. Do your research and don’t be afraid to travel, especially if you have the chance to see the best consultant who can offer the most effective treatment for you. Finally, don’t let the fear of pain put you off having surgery for haemorrhoids, because with the operation I had, I experienced very little.”