Simple treatments

In the first instance, haemorrhoids can be treated with creams available over the counter at the pharmacy. It is important to increase the fibre in your diet and drink 2-3 litres of fluid a day, taking laxatives where needed, in order to produce a soft, mushy stool which is easy to pass and prevents straining, which can lead to haemorrhoidal engorgement.

Surgical treatments

If simple measures do not help, there are a number of surgical treatments which Mrs Badvie may offer you. Treatments will be discussed with you in detail during your consultation, including risks and benefits, in order to select the most appropriate method for your case. After any treatment, it remains important to avoid straining and constipation, and to maintain a high fibre diet and to drink 2-3 litres of oral fluid a day, in order to produce a soft, mushy stool which is easy to pass. An outline of available treatments is provided below:

Injection sclerotherapy – using a small camera (‘proctoscope’) for guidance, Mrs Badvie injects a substance (5% phenol in oil) around the haemorrhoids which causes the haemorrhoidal blood vessels to shrivel away by a process called fibrosis. Up to three treatments may be needed for the full effect, six weeks apart.

Banding of haemorrhoids – using a small camera (‘proctoscope’) for guidance, Mrs Badvie applies small rubber bands to the haemorrhoids. This causes the tissue to lose its blood supply and shrivel away. Banded haemorrhoids fall unnoticed during a bowel movement into the toilet 7-10 days later, and no further treatment is required.

Haemorrhoidal artery ligation operation (HALO) – this procedure is an operation which Mrs Badvie performs with patients under general anaesthesia. A full examination of the anus and rectum is first undertaken. The haemorrhoidal blood vessels are located and stitched closed so that blood to the haemorrhoid no longer flows. This causes the haemorrhoid to shrink away. Mrs Badvie also lifts any haemorrhoidal tissue by a further stitching procedure which fixes the tissues in place. The National Institute for Clinical Excellence (NICE) have approved the use of this new HALO technique as a suitable alternative to conventional open haemorrhoidectomy and stapled haemorrhoidectomy (see below).

Open haemorrhoidectomy – this is the traditional operation for cutting away haemorrhoids under general anaesthetic and remains a suitable option in some patients. A full examination of the anus and rectum is first performed and the haemorrhoids are then removed.

Stapled haemorrhoidectomy – this is an operation performed under general anaesthetic. A full examination of the anus and rectum is first undertaken. A stapling device is used on the rectal tissue above the haemorrhoids, to trap and seal the blood vessels which allow blood to engorge the haemorrhoids. The haemorrhoids subsequently shrink away.

At the end of any operation for haemorrhoids under general anaesthetic, Mrs Badvie administers local anaesthetic (a ‘pudendal nerve block’) to reduce any pain on awakening from general anaesthetic.

Mrs Badvie provides her expert opinion to help Bupa produce up-to-date and informative guidance for patients seeking advice and answers to questions on haemorrhoids (also called piles):
https://www.bupa.co.uk/health-information/digestive-gut-health/haemorrhoids