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Embarrassing Bodies Down Under, 12:25am Friday 28th November 2014 on More 4. Catch up for free on 4oD »

Video

Voiceover:
Adrian came to see Dr Christian about painful piles.

Dr Christian:
Well, I can see them from here, I’ll tell you that now, so those are definitely haemorrhoids. You haven’t got…

Voiceover:
Dr Christian sent him to colorectal surgeon Mr Tariq Ismail.

Mr Ismail:
We’re going to look at your back passage, and, uh, see what’s, what’s going on there. I think it’s quite clear that he has quite dramatic, large piles, what we call haemorrhoids. And these are prolapsing out. And what we see here is the internal lining of the back passage as cushions to the haemorrhoids, a large external component of haemorrhoids, which is the skin around the anal canal, the back passage. This is important to examine the back passage to make sure there’s no spasm of the muscles in the back passage, and there isn’t a fissure, and making sure there’s nothing else on the inside like a growth or a polyp.

Voiceover:
Mr Ismail uses a device called a proctoscope to examine the anal passage and the lower rectum.

Mr Ismail:
He…his haemorrhoids are clearly large, uh, worse than most people’s, and are eminently suitable for surgical treatment. Once we’ve done the operation, he should be, uh, dramatically better. There should be nothing coming down, his bleeding should all settle, and the soreness and the irritation he’s had should also go away.

Voiceover:
A few weeks later, Adrian is back for his operation. Adrian is having a new procedure called a Halo. Unlike older techniques, it removes piles without cutting.

Mr Ismail:
So what we’re going to do is start the operation by inserting our…device into his back passage.

Voiceover:
Mr Tariq Ismail is one of the few experts in the country who performs the Halo procedure, that uses an ultrasonic probe to locate the arteries that supply blood to the piles.

Mr Ismail:
Switch it on. And some background noise…and as we rotate the uh, device, you can hear the arterial pulsation of the haemorrhoidal artery.

Voiceover:
Having found the artery, the surgeon ties it to stem the flow of blood feeding the haemorrhoid.

Mr Ismail:
So that’s one vessel ligated. We’ll, uh, switch the probe on again, see if we can… Another strong signal there. Reduce the blood supply to the haemorrhoidal area and then treat the prolapse at the same time with a simple stitch to hitch up the loose skin, hopefully we can revolutionise his life. Okay, I think it’s time to take this device out and see how it looks. Um, that big prolapsing haemorrhoid has now pretty well disappeared. I’m quite pleased with that, there’s probably one more to do at the top there, eleven o’clock position. And we’re almost finished.

Voiceover:
Mr Ismail is happy with the progress and tackles the remaining pile.

Mr Ismail:
This is our finished result, and you can see that the prolapse is now gone. Under the circumstances, considering he had large prolapsing haemorrhoids, that’s a very good result.

Voiceover:
Older techniques would require a six week healing time. After this little lot, he could be back to work in as little as 48 hours.

Mr Ismail:
We were able to find um, eight vessels today. A little bit more than normal, but we were able to successfully ligate all these vessels, and then hitch up the prolapse at the end of the operation. So it’s a two-stage repair, but I’m very pleased that it went well, and I’m very hopeful that Adrian’s going to be pleased with the outcome.

Voiceover:
A month later, Adrian is back at the clinic for a checkup with Dr Christian.

Dr Christian:
Hi, how are you, nice to see you again.

Adrian:
Hiya.

Dr Christian:
Go on, have a seat. So, how was the operation?

Adrian:
Well, before the op, I was in a lot, a lot of pain, I wasn’t even sure they were going to be able to operate, you know.

Dr Christian:
And how much bleeding did you experience afterwards?

Adrian:
I had a little bit, but nothing…less than it was before, really, and I think that’s just stitches and everything, so.

Dr Christian:
And so there aren’t any new haemorrhoids appearing since?

Adrian:
I don’t think so, I’ve started putting a bit of cream on, just to keep it under control, but it’s nowhere near what it was.

Dr Christian:
Well, let’s go and have a quick check to see how you look now and make sure you’re healing properly, to start with, and that…well, I’d like to see how it looks, that the haemorrhoids are gone. Come over to the bed with me.

Adrian:
Okay.

Dr Christian:
All right, so you’re not in any pain at the moment?

Adrian:
No, it’s fine.

Dr Christian:
Let’s have a look. Well, that’s a very different-looking bottom indeed. You’ve got absolutely no haemorrhoids at all. One or two tiny little skin tags left over, but otherwise, it’s back to normal.

Adrian:
Yeah.

Dr Christian:
You happy with that?

Adrian:
Yeah, it’s just uh, life-changing, I’m really happy I had the operation.

Dr Christian:
I think that’s a really good result for a, you know, very straightforward operation, really.

Adrian:
Yeah.

Dr Christian:
It’s extremely successful, and you were in pretty much a lot of discomfort before, weren’t you?

Adrian:
Terrible.

Dr Christian:
Yeah, so it’s done. Brilliant. That’s a good result, thank you, you can get yourself dressed.

Read the video transcript

Dr Christian met Adrian who suffered from severe piles or haemorrhoids. After Dr Christian examines the afflicted area he also notes a possible rectum prolapse and sends him to Dr Tariq Ismail who conducts a new procedure called Haemorrhoidal Artery Ligation Operation (Halo). After just two hours there was already a visible improvement and a few weeks later the piles had vanished altogether.

Patient Name: Adrian Hill
Condition: Piles
Specialist: Mt Tariq Ismail, Consultant Colorectal Surgeon
Birmingham Bowel Clinic
Hospital: BMI, The Priory Hospital
Length of Operation: Approx 20 minutes

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Comments and Questions

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I had the op 6 days ago, I'm still in immense pain. I was initially having what can only be described as anal contractions each time I needed to do a BM. Still I am having between 10-20 BM's a day - some very small and others so significant I have no idea where they're coming from as I'm not eating much! I'm drinking 8-12pints of water a day as advised, I suffer IBS so do not take the lactulose/husks as they irritate me, instead I am eating "scanbran" when needed (only needed on day 2 so far) and a high fibre diet with a variety of fruit and veg. I have attempted to go out, been almost disastrous as the urgency to go is ridiculous. I have a very very sudden and extremely painful downward pain, this worsens and I have to go. I've read on other sites now and realise I'm not alone. I've got some lidocaine gel that I am applying before I eat in the morning to "numb" the area. I'm having regular baths to help the pain. I took the antibiotics but am sure they didn't help. The Tramadol make me feel spaced out but they are the only thing that help - I asked GP for an alternative which was a Co-Codomol variety but they didn't do a thing not helped by being unable to double up with paracetamol and ibuprofen which I can with tramadol. Feel like a walking pharmacy who can't go far for fear of an incident! Supposed to go back to work in 4 days, work in a school so not a hope in hells of that!!! Really want to know that it will get better...... please!





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I have been taking laxatives for about 20 years now. A year ago I had 3 internal piles banded. Now for about 8 weeks I am in terrible pain in my colon, worse after toilet but does not stop during the day, I take morphine for it as other painkillers stopped working. My GP keeps saying that I have piles again and keep on prescribing steroid creams but they don't make any difference. What should I do?





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My Partners got one large lump on his anus its just a bit bigger than a grape about 2-3 cm hes had it for about a year but its only just started hurting him in the last 2-3 days he used to be able to push it back in but thats not the case anymore and is in a lot of pain does anything know/think weather he would need surgery





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I'm 42 now suffered from constipation and piles sine 13 yes old, went onto have 2 children, last child birth more difficult left with Painful!! Bleeding piles, and 2 fissures, pain is now unbearable l go to see specialist this week,really bricking it, don't want anyone to go near them, pin is that bad!! Tried all creams,pressaties, cider vinegar',hot baths salted soothe, generally thy need too come out, l can't have anymore painkillers!!





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can really some one cure haemmorids naturally ?. And if so , with what





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Hi Can anyone tell me if this procedure is done in South africa.





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two and a half weeks after the thd procedure and I am still having problems standing up without feeling everything is heavy and 'dragging' and getting that awful frequent feeling that I need to be going to the toilet when I don't - although my ibs means that sometimes I do! I am worn out with it all now, and going mad staying indoors. this procedure should not state that recovery is really fast, as it clearly isn't, I thought I would be fine by now, and I am gutted that I'm not.





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Please can you tell me how things progressed? I'm having similar issues, I am on the toilet at least 5 times after breakfast with little/no warning just a sudden overbearing pain and sprint. I'll have a reprieve until I have drunk a few pints of water/1 cup coffee/eat lunch and it starts again .... Having to continue with tramadol as pain is incredible - worse than childbirth! Looking for light at the end of the tunnel!

My boyfriend has just had this HALO procedure done today and has stayed in hospital overnight because he has no sensation in his genitals and has had to have a catheter put in, otherwise he is perfectly comfortable. He is obviously concerned about this and I was wondering if anyone else out there has had this problem, and if so, how long does it last...hopefully, all sensation will come back! Please if someone can reassure us, we would be most grateful.





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In reply to my own question...I would like to reassure anyone else who does have this happen to them, that it was short lived. All sensation came back within 24hrs and any concerns regarding erection dysfunction were allayed.

The screens to watch the videos are too small. Also I don't like the way the camera is swinging about during each of your programmes. I wish to keep anonymous.





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Hi I'm 20 years of age and I'm a male. Can you guys please tell me how long does pile pains take to go away and what's the cause of this pain





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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