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Haemorrhoids (piles)

Everyone has swellings in their anus known as anal cushions. These are normal structures that are made up of blood vessels attached to the wall of the anus and help to provide an airtight and watertight seal to the anus. In some people they can become stretched, when they become known as haemorrhoids. This is often because of constipation and straining. They are also common during and after pregnancy. In other people, they occur without any obvious cause.

They may occur predominantly within the anal canal (internal haemorrhoids) when bleeding is a common symptom or on the outside, around the anus itself (external haemorrhoids). When on the outside, they might cause bleeding, pain, itching, lumpiness and problems with keeping clean.

Many of the symptoms of haemorrhoids can be improved with changes to the diet, particularly increasing fibre intake, and by making efforts to reduce straining. Other haemorrhoids might be assessed as suitable for out-patient procedures such as banding or injection.

For some patients with large haemorrhoids and significant symptoms unresponsive to conservative measures, surgery may be indicated. Traditionally, this has involved cutting away the haemorrhoids under a general anaesthetic. There are, in addition, newer treatments which are also available in Oxford, which may be suitable for some patients with haemorrhoids. They include stapled haemorrhoidectomy (PPH) and HALO (www.halocentre.com).