Treatments for Haemorrhoids

Injection, Banding, Doppler-Guided Haemorrhoidal Artery Ligation,
Recto Anal Repair, Stapled Haemorrhoidopexy

 

Berkshire General Surgeons are at the forefront of revolutionary treatment for haemorrhoids, using minimally
invasive techniques including HALO to improve recovery dramatically and reduce the risk of complications

Haemorrhoids, also known as piles, are enlarged and swollen blood vessels in or around the lower rectum and
the anus. (The lower rectum is the final part of the bowel and the anus is the opening at the end of the bowel).
Haemorrhoids are very common particularly during pregnancy and immediately after childbirth. They are not
life-threatening, but they can cause itching, bleeding and pain. Internal haemorrhoids develop in the lower rectum,
a few centimetres above the opening of the anus. If they extend out of the opening of the anus, they are described
as ‘prolapsed’.

Haemorrhoids can often be successfully treated by simple measures such as eating more fibre and drinking more
fluid. If these simple measures are unsuccessful, haemorrhoids can usually be treated successfully in a clinic.
Local treatments include ‘injecting’ or ‘banding’ the haemorrhoids.

There are several surgical approaches to dealing with larger or resistant haemorrhoids (piles) that cannot be
treated in the clinic or at home.  The choice of treatment is dependant on the patient and their condition.

Injection
Injection is a common outpatient treatment for haemorrhoids.  The advantages are that it has few side-effects,
does not require hospital admission or anaesthesia and is frequently successful. The disadvantages are that
it may require repeating as a course of injections (usually up to three) and that it can sometimes cause pain
and bleeding.

Oily phenol is injected into the base of each pile to scar the blood vessels supplying the pile. Over time this
can lead to shrivelling of the piles and a reduction in the symptoms they cause.

Pain is generally uncommon and often does not occur immediately, though some discomfort may be experienced.

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Banding
Banding is a common outpatient treatment for haemorrhoids.  The advantages are that it has few side-effects,
does not require hospital admission or anaesthesia and is frequently successful. The disadvantages are that
it may require repeating as a course of bandings (usually up to three) and that it can sometimes cause pain
and bleeding.

Small rubber bands are applied to the base of the piles to cut off the blood supply. Over time this can lead
to shrivelling of the piles and a reduction in the symptoms they cause.

Pain is generally uncommon and often does not occur immediately, though some discomfort may be experienced.

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Doppler-Guided Haemorrhoidal Artery Ligation (HALO, DGHAL and HAL-RAR)
The HALO technique and its modifications have revolutionised the treatment of haemorrhoids.  Doppler-guided
haemorrhoidal artery ligation is the first system to utilize minimally invasive surgical techniques to treat the source
of haemorrhoids without surgical excision, stapling or banding.

It interupts the blood supply for the haemorrhoid which reduces the likelihood of it prolapsing back into the anal canal.

As the procedure is almost pain free it can be performed as a day-case operation and in most cases patients can
return to work considerably quicker than after an open procedure.

For further information on this procedure please visit the British Haemorrhoid Association

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Recto Anal Repair
Recto Anal Repair is a new operation to control prolapsing haemorrhoids.

Essentially it involves some dissolving stitches being inserted into the lining of the rectum, which then puts a pleat
in the mucosa and draws the pile back up into the anal canal. 

The operation tends to be quite uncomfortable afterwards but fortunately the pain usually lasts for only three
or four days.

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Stapled Haemorrhoidopexy (PPH - Procedure for Prolapse and Haemorrhoids)
In stapled haemorrhoidopexy a specially designed circular stapler is inserted into the rectum. It is used to cut
out a strip of the tissue above the haemorrhoids in an area of the rectum that doesn’t feel much pain. The
operation helps to reduce the haemorrhoids. It also helps shrink the remaining haemorrhoids by reducing their
blood supply and makes them less likely to extend out of the anus.

The main advantage over the open procedure is that all of the ‘work’ of the operation is performed inside the anal
canal, which is considerably less sensitive than the skin bearing area around the anus where the open procedure
is performed. The other advantage of the operation is that it leaves the haemorrhoids behind, but in the correct
position and much smaller.

As the procedure is almost pain free it can be performed as a day-case operation and in most cases patients
can return to work considerably quicker than after an open procedure.

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