Haemorrhoids (piles) are very common. They often present with bright red bleeding from the back passage either on the toilet paper or in the toilet basin. Haemorrhoids are essentially enlarged veins around the back passage. They are graded from grade 1 (internal haemorrhoids), grade 2 (haemorrhoids that occasionally prolapse outside and return by themselves), grade 3 (haemorrhoids that prolapse outside and require a finger to put them back) or grade 4 haemorrhoids which are permanently prolapsed haemorrhoids.
If you have bleeding from the bowel, we will perform a thorough assessment, including history and clinical examination. This involves a rectal exam and sometimes a telescopic evaluation of the anal canal and rectum (proctoscopy or rigid sigmoidoscopy).
Once a diagnosis of haemorrhoids is established, we can offer treatment. This may either be dietary advice, creams, or medication such as laxatives. Additional treatments that we offer includes banding of the haemorrhoids to shrink them, which can be done in the clinic. For patients needing surgery for their haemorrhoids, we provide surgical excision of the haemorrhoids (haemorrhoidectomy) or doppler-guided transanal haemorrhoidal de-arterialisation (THD)/haemorrhoidal artery ligation (HALO) procedure where the artery feeding the haemorrhoid is tied off with a stitch. This can be combined with a recto-anal repair (RAR) which may be required if there is an element of prolapse.