Haemorrhoids, or piles, are a common problem in men and women of all ages. About one third of people will suffer from them from time to time.

The normal anal canal has little cushions of blood vessels that are essential to create an airtight seal between the circular sphincter muscles. Over time, these cushions can become enlarged, stretched, and can start to descend inside the anal canal. When they start bleeding or protruding from the anus we call these (symptomatic) haemorrhoids.

They often occur in people who are constipated and strain, though some sufferers will have normal bowel habits. Sometimes they can be a manifestation of an underlying problem such as internal or external rectal prolapse.


They can cause a number of symptoms including:

  • bleeding, usually bright red blood on the toilet paper.
  • prolapsing lumps (lumps that hang out from the anus either all the time or after opening of bowels).
  • Tenderness or pain, especially during bowel movements. If haemorrhoids are ‘thrombosed’ (form a blood clot) they can be extremely painful.
  • Anal itching.
  • Soiling or discharge of mucus from the back passage.


The surgeon seeing you can perform an examination in clinic (proctoscopy or rigid sigmoidoscopy). Often a flexible sigmoidoscopy or colonoscopy may be necessary to rule out other causes of your symptoms. Your symptoms and the grade of your haemorrhoids will define the best treatment for you.


Early haemorrhoids can often be treated with dietary changes, using diet, hydration and stool softeners such as Fybogel or Laxido to keep stool soft. It is also important to ensure a good toilet habit; it is particularly important to avoid straining or prolonged sitting - reading whilst on the toilet is discouraged!

In more advanced cases, treatment may be necessary.

Banding involves placing rubber bands on the haemorrhoids. It works by cutting off the blood supply to the haemorrhoids, allowing them to shrivel away. The contracting scar tissue will also pull the heamorroidal cushion back in to its normal position. Banding is a safe procedure but can be associated with minor discomfort for 48 hours and bleeding one to two weeks after the procedure. It can be performed without need for sedation in clinic or during your sigmoidoscopy or colonoscopy.

Injection of a sclerosing substance into haemorrhoids works by reducing the blood supply to the haemorrhoids. A sclerosing substance such as oily phenol can be injected into the haemorrhoids under local anaesthetic. After a few days the haemorrhoids will shrink. It is usually carried out as a day case procedure in the Endoscopy Unit or occasionally in clinic.

Banding and injection provide effective treatment for many people with haemorrhoids. However symptoms may return over months or years and repeat treatment may be considered.

More advanced haemorrhoids, especially those that hang down from the anal canal, are often treated with surgery. This may involve removal by haemorrhoidectomystapled anopexy (also known as Procedure for Prolapse and Haemorrhoids or PPH) or Haemorrhoidal Artery Ligation Operation (HALO).

All haemorrhoid treatments tend to cause soreness for a few days, especially when sitting or moving the bowels, and bleeding or itching may also occur. Haemorrhoidectomy can be very painful for one to two weeks after surgery.

Please be advised that the information on this website is not a substitute for professional medical advice, diagnosis or treatment