What should I do about my haemorrhoids (piles)?

Most people are under the impression that having haemorrhoids (or piles) is a medical condition. The truth is that everybody has haemorrhoids, and simply some people have larger and more problematic haemorrhoids compared to others.

Introduction

Most people are under the impression that having haemorrhoids (or piles) is a medical condition. The truth is that everybody has haemorrhoids, and simply some people have larger and more problematic haemorrhoids compared to others. Haemorrhoids are a part of our normal anatomy within the bottom (anal canal). They are swollen cushions made of blood vessels that contribute to the fine control of continence. Haemorrhoids exist in varying grades of severity (one to four) and the symptoms you may experience do not always accurately reflect the severity of your haemorrhoids. The tricky part is knowing what to do about it.

Symptoms
The most common symptoms of haemorrhoids are rectal bleeding, pain, itching (pruritus) and swelling around the anus. Rectal bleeding is the most common problem. The blood is usually bright red and may drip, squirt into the toilet bowl, or appear as streaks on the toilet paper. Pain truly caused by haemorrhoids usually arises only with acute thrombus (clot) formation. This pain peaks at 48-72 hours and begins to decline by the fourth day.

Investigation
Most people who experience recurrent rectal bleeding are anxious about having a large bowel tumour. Other possible causes of rectal bleeding include inflammatory bowel disease (Crohn’s disease or ulcerative colitis), anal fissure, colorectal polyps and rectal prolapse.

In order to exclude these, most patients are recommended to undergo one or a combination of tests to investigate the lower gastro-intestinal tract, depending on co-existing symptoms, family medical history and patient preference: proctoscopy, rigid sigmoidoscopy, flexible sigmoidoscopy, colonoscopy or CT virtual colonoscopy.

Treatment
There are several treatments available for haemorrhoids and having a surgeon experienced in all available techniques means you can choose which treatment is best for your individual circumstances.

Simple haemorrhoids can be treated conservatively with lifestyle changes such as re-training not to strain on the toilet, or with the addition of simple medicines such as laxatives. If this does not improve the symptoms then the least invasive and safest treatment is banding.

For larger and more symptomatic haemorrhoids there are intermediate treatments available such as trans-anal haemorrhoid dearterialisation (THD) procedure. This technique reduces the flow of blood to the haemorrhoids and in turn reduces bleeding. The THD procedure is usually combined with rectal mucopexy, which corrects the prolapse of haemorrhoids to and restores them to their normal position within the anal canal. 

The Rafaelo procedure is an innovative treatment designed to cure haemorrhoids in a minimally invasive way, with no cuts made into the tissues. It uses well established radio frequency technology to shrink haemorrhoids and can be applied to all grades of haemorrhoids. The main advantages are minimal post-operative pain, if any at all, and immediate return to normal daily activities.

Surgical removal of haemorrhoids (haemorrhoidectomy) is reserved for the most troublesome haemorrhoids that have either not responded to less invasive treatments or are not suitable for them. Although effective, it can be a more uncomfortable treatment. 

Conclusion
Your investigation and subsequent treatment is an agreement between you and your surgeon and can only be achieved during your consultation. This is allows the treatment to be tailored to your individual needs.

For more information or to book an appointment please call us on 0151 929 5408 or send an enquiry.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.