Your anus is lined with a sponge like tissue which is supplied with blood vessels and helps your anus to close.  Sometimes the blood vessels can become enlarged and become round discoloured lumps (piles or haemorrhoids) which can then cause symptoms such as pain, a feeling of fullness in your anus, bleeding when you poo or a mucous discharge.

Haemorrhoids are a relatively common complaint - around half the UK’s population will develop haemorrhoids at some point during their life. There are also different types of haemorrhoids and these are classified according to the level of protrusion outside the anus.

The exact cause of haemorrhoids isn’t clear, but they occur when the veins in your anal canal become swollen.

Straining and constipation when opening your bowels may make symptoms worse. Haemorrhoids are also very common during pregnancy, due to increased pressure on the pelvic blood vessels. Chronic (long-term) diarrhoea can also make you more susceptible to haemorrhoids.

You may be more prone to developing haemorrhoids due to:

• Pregnancy
• Regularly lifting heavy objects
• A persistent cough or repeated vomiting
• Constipation or straining when going to the toilet

Haemorrhoids are usually painless and often don’t cause any symptoms, so many people don't even realise they have them. However, you may notice some of these common haemorrhoid symptoms:

• An itchy bottom
• A red or sore anus
• Swelling around your anus
• Bleeding (bright red blood) from the bottom after passing a stool
• A haemorrhoid can feel like a lump hanging outside or a mucus discharge from the anus after passing a stool

If you’re experiencing persistent or severe symptoms of haemorrhoids - particularly pain or bleeding - you should speak to your GP. They should be able to rule out more potentially serious causes.

Piles are often dark bluish in colour due to the blood being pushed to the surface. They look like little lumps around the anus and it might help to have a mirror handy to check. However, it’s always best to see your GP if you have any concerns.

If you think you have haemorrhoids, the first step is to see your GP. It’s only natural that you might feel embarrassed, but don't let that stop you seeking help. It’s a common complaint that GPs are used to dealing with.

Your GP can usually diagnose haemorrhoids with a simple examination of your back passage, although they may need to refer you to our Consultant Colorectal Surgeons for diagnosis and treatment.

Haemorrhoids often clear up by themselves, without intervention, after a few days. Often simple dietary changes and self-care can help reduce the occurrence of haemorrhoids. For example, if constipation is the cause, then extra fibre in your diet will keep your stools soft and avoid the need for straining.

If you’re experiencing itching and discomfort there are many readily available, over-the-counter treatments or piles cream that can reduce these symptoms. You can speak to a Pharmacist to find the best haemorrhoid cream for you.

If your symptoms are more severe, you may need further private treatment for haemorrhoids, such as:

• The Rafaelo® Procedure (shrinking and eliminating haemorrhoids using radio frequency energy).
• Banding of haemorrhoids (removing them by restricting their blood flow)
• Haemorrhoidectomy (the surgical removal of haemorrhoids)

Your Consultant will recommend which treatment for haemorrhoids is best for you.

Rafaelo® Procedure

The Rafaelo® Procedure is a minimally invasive procedure for internal haemorrhoids. During the operation, a special needle probe is inserted into the haemorrhoidal cushion. Radio frequency energy is passed through the needle into the tissue, which heats it, reducing the blood supply and shrinking the haemorrhoid.

It typically takes around 20 minutes to perform and you’ll be given a local anaesthetic or mild sedative (although some patients choose to be treated under general anaesthetic).

After the Rafaelo® procedure, you’ll need a few days to fully recover, depending on the severity of your haemorrhoids. We’ll send you home with painkillers and may be able to continue with your normal routine within a day or two. You will have a follow-up appointment a few weeks after the operation.

Find out more about the Rafaelo® Procedure.

Banding (ligation) of haemorrhoids

This is a routine, non-surgical procedure for internal haemorrhoids which takes a few minutes to perform and isn’t painful. Your Consultant or Nurse will use a small instrument to attach a tight rubber band around the base of the haemorrhoid. The band constricts the blood supply to the haemorrhoid, causing it to fall off.

It should relieve your symptoms within 10 to 14 days.

Haemorrhoidectomy

Your Consultant will use a special device during an examination under anaesthetic to see the haemorrhoids more clearly, before removing them by cutting them out. They’ll stitch the lining to the underlying muscle to prevent recurrence. Most of the stitches are inside the anal canal and will dissolve over a period of two to four weeks. In some cases, the wound is left open to heal.

The Consultant might also place a small pack inside your rectum to stop any bleeding. This will be passed with your first bowel movement.

Patients may experience discomfort, mild bleeding and some anal discharge after the operation. In rare cases, complications such as anal fissures or more significant bleeding may occur. We will always discuss any risks with you before carrying out the procedure. 

In a small number of cases, banding of haemorrhoids can cause bleeding, pain and ulcers (open sores). The procedure may not be suitable if you're taking anticoagulant medication for other conditions. We always discuss any risks with you before carrying out the procedure.