Embarrassing Illnesses

If injections or banding haven’t worked, or if your haemorrhoids are large and causing you a lot of pain and discomfort, you might be referred for a haemorrhoidectomy. This is an operation to remove the piles and is usually done under a general anaesthetic. 

A traditional haemorrhoidectomy involves gently stretching the anus while the haemorrhoids are cut away.

It's less likely that the haemorrhoids will come back with surgery than it is with injections or banding. But a high fibre diet is always recommended as a preventative measure. 

This is a major operation and you would need to take a week or so off work while the wounds heal.

Unfortunately it's common to have pain after this procedure, but you'll be given painkillers to help you deal with it. You may still have some pain for a few weeks afterwards, but this can be controlled with painkillers. If the pain goes on for longer, you should seek medical advice.

Again, lots of bleeding needs to be treated as an emergency.

Alternative procedures

Stapling

Stapling is an alternative to a traditional haemorrhoidectomy. It's usually only done to treat prolapsed haemorrhoids and is carried out under general anaesthetic. The piles are stapled to the wall of the anal canal, which reduces their blood supply and makes them smaller.

In general, you could return to work within a week or so.

Not all hospitals offer this method as it's still relatively new. Check with your GP if it's available in your area.

There was some controversy in the past about stapling - it was thought that the risks of haemorrhage and infection were greater than with having a traditional haemorrhoidectomy, where the piles are cut out. However, several clinical trials have been carried out in the meantime which show that neither procedure is riskier than the other. Both are safe for most people who have them. Stapling has the advantage of having a shorter recovery time and it also tends to be less painful than a haemorrhoidectomy.

Haemorrhoidal artery ligation operation (HALO)

This is a relatively new technique, which is currently only available in a few NHS hospitals and private clinics. During this procedure a miniature ultrasound device is used to locate all the areas in the bowel where an artery supplies blood to a haemorrhoid. A stitch is then placed in these areas so that the blood supply to the pile is tied off. Over the next few days and weeks the pile shrinks away.

Other treatments

A few other options are available, but like HALO, only a few surgeons carry them out on the NHS or in private clinics. These include freezing and laser treatment.

view information about Haemorrhoids on www.nhs.co.uk »