Haemorrhoids

Understanding Haemorrhoids (Piles)

Advice from Consultant Colorectal Surgeon, Mike Williamson

Haemorrhoids are small, blood vessel-rich lumps found inside everyone’s bottom (anus). They are completely normal, but sometimes they become enlarged and start causing symptoms. When this happens, they are often referred to as piles.

Common Symptoms of Haemorrhoids

If your haemorrhoids become troublesome, you might notice:
•    Bleeding (often on toilet paper after wiping)
•    A feeling of lumps coming out of the bottom, especially during bowel movements (called prolapse)
•    Itching or discomfort around the anus.

In many cases, these symptoms settle on their own or can be eased with over-the-counter creams or ointments from your GP or pharmacy.

When Haemorrhoids Don’t Go Away

Sometimes haemorrhoids don’t improve with simple treatments. You may experience:
•    Ongoing or heavy bleeding
•    Persistent prolapse (lumps that remain outside the bottom)
•    Difficulty cleaning properly after using the toilet
•    Rarely, very painful swelling if the haemorrhoids clot (called thrombosis).

When this happens, it’s time to see a specialist like me for further advice or treatment.

Could It Be Something More Serious?

Seeing blood when you wipe can be worrying - especially if it's the first time. Many people fear it could be bowel cancer. While haemorrhoids are a common cause, it's important to rule out other conditions. 

Depending on your age and symptoms, I may recommend a colonoscopy before starting treatment for haemorrhoids.

How Are Haemorrhoids Treated?

Some people feel embarrassed talking about haemorrhoids, but there’s no need to suffer in silence. This is a common problem, and there are effective treatments available.
I’ve spent 30 years helping patients with haemorrhoids, and I always start by listening carefully and explaining your options clearly.

Conservative (Non-Surgical) Treatment

This is always the first step:
•    Eat a high-fibre diet
•    Stay well hydrated
•    Use mild laxatives if needed
•    Try over-the-counter creams or suppositories

For many people, these changes are enough to improve symptoms. Current NHS guidelines ask GPs to try these conservative treatments for 6 months before referring for surgery - and that’s usually a good approach.

Surgical and Minimally Invasive Options

If symptoms continue, there are several procedures I can offer:

Rubber Band Ligation
•    A small band is placed around the haemorrhoid to cut off its blood supply
•    Done in the clinic, usually with little discomfort
•    Works well in the short term, but only about 25% of people get long-term relief

Stitching Techniques: HALO or THD
•    Use a special probe to find the blood vessels feeding the haemorrhoids, which are then tied off. The haemorrhoids themselves are then sutured to shrink them.
•    Less painful than traditional surgery
•    Some discomfort is expected for a few days afterwards

Haemorrhoidectomy (Surgical Removal)
•    This involves cutting out the haemorrhoids completely
•    It’s the most effective option for severe or persistent cases
•    Recovery can be painful, especially during the first week
•    Despite this, most people are very glad they had it done

Life After Treatment

People often tell me that their symptoms had a big impact on their quality of life - constant bleeding, discomfort, or worrying about accidents when out and about.

After surgery, especially a haemorrhoidectomy, they often feel a huge sense of relief, being free of bleeding, prolapse, and the need to manage uncomfortable symptoms every day can be life-changing.

Patient-Centred Care

When you come to see me, we’ll have an honest and thorough conversation about:
•    What are haemorrhoids.
•    Why are yours causing symptoms.
•    What treatment options might work best for you.

You will be fully involved in choosing the right treatment path. I’ll always be honest about the benefits and the potential downsides, including recovery time and discomfort.

Book a Consultation

If you think you might need help or just want some reassurance, it’s easy to book a consultation with me. Please contact my private secretary, who will be happy to find a time that works best for you.