Haemorrhoids or piles are fleshy lumps containing blood vessels. They are found in and around the anus and rectum.
Haemorrhoids can be symptomless and often clear up on their own or with treatments available at pharmacies. However, if you are experiencing persistent discomfort, recurrent bleeding or prolapse (haemorrhoids coming out of your anus), you may need to see a colorectal specialist.
If you are experiencing troublesome haemorrhoids, there’s nothing to be embarrassed about. Haemorrhoids are one of the most common conditions seen by colorectal consultants.
What are haemorrhoids?
Haemorrhoids are sponge-like structures that sit under the lining of the lower rectum (back passage.) They are part of the mechanism that helps you stay continent. If they become enlarged due to straining or pressure, they can drop down into the anus our even outside it.
Once they become enlarged or are hanging down, they can be traumatised by a bowel movement, which causes bleeding. This blood is bright red and painless. The issue is that you can’t give the area time to rest and heal, so the wound can reopen every time you use the toilet for a few days or weeks.
What causes haemorrhoids?
Human beings are prone to haemorrhoids because we stand in an upright position. They can also be caused by giving birth, being overweight and chronic constipation.
What are the symptoms of haemorrhoids?
One of the most common symptoms of haemorrhoids is bleeding when you have a bowel movement. This blood will be fresh and bright red. If the blood is dark, it may be from further up in the bowel and need further investigation.
Haemorrhoids can be itchy. You may also be able to feel lumps around your anus, and or feel like you aren’t completely clean after wiping.
Haemorrhoids appear in varying degrees:
• 1st degree – the haemorrhoid is within the low rectum, but it may still bleed.
• 2nd degree – the haemorrhoid bulges from the anus when you go to the toilet.
• 3rd degree – the haemorrhoid presents externally but can be pushed back in with a finger.
• 4th degree – the haemorrhoid is outside the anus at all times.
Your haemorrhoid removal questions answered
Yes. It is possible that your haemorrhoids will improve on their own and that standard painkillers (such as paracetamol) can be used to help with the pain.
You could also try eating more fibre and drinking more water. Many patients find that medication from a pharmacy helps.
Your GP is likely to recommend trying these conservative measures first. However, if these methods don’t work or your piles are severe (3rd or 4th degree), then you may be referred to a colorectal specialist.
When you are referred to a colorectal specialist, they will want to make sure that the bleeding is haemorrhoidal and not coming from further up in the bowel.
They might ask you about the history of the pain or bleeding you’re experiencing and whether there is any history of bowel cancer in your family.
There is likely to be a physical examination, which involves feeling to see if there are any lumps in the area. A proctoscope (a hollow tube) may also be used to take a closer look.
If your haemorrhoids are 1st or 2nd degree, your consultant may recommend rubber band ligation. This is a localised treatment which involves using rubber bands to cut off the blood supply to the haemorrhoid.
Surgery may be recommended for patients who are experiencing haemorrhoids that are 3rd or 4th degree.
The aim of a haemorrhoidectomy (haemorrhoid removal surgery) is to remove the haemorrhoids that are causing discomfort or pain. It is a very good and often permanent treatment for haemorrhoids. However, the recovery can be very uncomfortable for a week or two, especially when you first open your bowels. For this reason, if the haemorrhoids are suitable, most colorectal surgeons will choose to perform a suture repair of the haemorrhoids. This procedure is known as transanal haemorrhoidal de-arterialisation (THD) or haemorrhoidal artery ligation (HALO). THD/HALO involves reducing the blood supply to the haemorrhoids by identifying and suturing the main blood vessel. The haemorrhoid is further sutured to shrink it and pull it back into place in the low rectum. This approach recognises the function of haemorrhoids within the colon and aims to restore the anatomy. It is less painful to recover from but does have a higher rate of recurrence than excision.
In cases of extreme prolapse, your surgeon may rarely recommend stapled hemorrhoidopexy. This involves using a special circular stapler to remove a section of the lining of the bowel and fix the haemorrhoids in place.
If your consultant recommends surgery for your haemorrhoids, our team will ensure you know what to expect and are aware of any preparations you may need to make. For example, you will need to arrange for someone to pick you up from the hospital. You may be asked not to eat anything on the day of your operation or to stop taking certain medications.
All haemorrhoid operations are usually performed as a day case procedure, and all but banding is performed under a spinal or general anaesthetic.
You will want to get plenty of rest at first, but it’s also important to keep moving to prevent blood clots. Our team will make sure you know which exercises are safe to do, what medications to take and how to care for your wounds. You are likely to be prescribed laxatives to counteract the stronger pain medications or if you tend to suffer from constipation.
You may feel pain for up to a week, and longer after excision but the latest treatment techniques are designed to enhance your recovery and provide good long-term results.
All surgery has risks, including those associated with having an anaesthetic. These can include infection, pain, bleeding and blood clots. There are also complications specific to haemorrhoid surgery and whilst the main risks are bleeding (which can be up to two weeks after) and pain, others can include incomplete removal, anal tears and skin tags. More severe side effects, including possible mild incontinence or narrowing of the anal canal, are regarded as rare but potential complications of more difficult surgery.
Your consultant will discuss all the risks with you ahead of the procedure and make sure you are fully informed and happy to go ahead.
You may be covered by private medical insurance, or you may wish to consider spreading the cost of your surgery by opting for a monthly payment plan.
We aim to make our costs as transparent as possible, but it’s important to talk everything through in detail with your consultant at the time of your appointment. Some costs may be paid directly to the hospital, while others, such as your consultant fees, may be paid directly to the consultant.
Choose Sulis Hospital for your haemorrhoid surgery
Booking an appointment at Sulis Hospital General Surgery Unit means getting seen by a specialist and experienced consultant. You’ll also benefit from a timely appointment, with fast access to diagnostics and treatment.
If you do need surgery, you will be welcomed into a clean, modern hospital that invests in the latest treatments, diagnostic technologies and ways of working. We deliver an exceptional standard of care, which is why patients travel from all over the UK to have their surgery with us.
Combining a calming hospital environment with outstanding patient care so you can recover as quickly as possible.
Typical hospital stay Daycase
Covered by health insurance? Yes
Can I pay privately? Yes
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Mr Paul Durdey
Consultant General and Colorectal SurgeonView profile
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Consultant General SurgeonView profile
Mr Mike Williamson
Consultant General and Colorectal SurgeonView profile
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