The Rafaelo Procedure

As many as three quarters of people around the world will suffer from haemorrhoids are some point in their lives. A wide variety of treatments and procedures exist to help individuals deal with and recover from them, with different levels of success. Many treatments can be administered at home, but some require the intervention of a medical professional.

One relatively-new treatment, however, can completely eliminate haemorrhoids in a matter of minutes.

The Rafaelo procedure allows patients to avoid the stress and pain associated with major surgery, and grants them the chance to start going about their daily routines again immediately. It was first developed in Poland and has since been used to treat over 1,000 people in the UK and many more across the world.

Haemorrhoids occur when blood vessels in the rectum and anus come under increased pressure, causing them to inflame and swell. They can be itchy and painful, and can bleed in some cases.

They receive a grading from one to four, with one being the smallest and four being those that are external and require more comprehensive treatment. They cost the UK up to £2million in incapacity benefits every year as people take off work when the condition flares up.

The Rafaelo technique is unique in that it doesn’t require the patient to be anaesthetised throughout. It works for most internal haemorrhoid cases up to grade 4.

According to GI doctors: “Rafaelo stands for Radio Frequency Treatment of Haemorrhoids under Local Anaesthetic and the procedure is offered by experienced colorectal doctors qualified to carry it out. After being given a sedative to help you relax, a local anaesthetic is applied to the area of the haemorrhoid. A special device that emits a safe radio frequency energy is used to stem the blood supply to the haemorrhoid. This causes it to contract, producing virtually instant relief from symptoms.”

The procedure is now widely available in the United Kingdom, in many private hospitals and private clinics and also in a growing number of NHS hospitals. Spire St Anthony’s Hospital in Cheam, Surrey was one of the first to begin administering the procedure to the patients who could afford its considerable cost. Consultant colorectal surgeon Mr Nick West performs the procedure, which is similar to that which is used to cure varicose veins.

Describing the procedure in The Daily Mail, Mr West says: “The base of the haemorrhoid is injected with local anaesthetic. A special metal probe, the width of a knitting needle, is inserted into the haemorrhoid. Radio-frequency energy is then sent down the probe. You can see the haemorrhoid shrinking.”

Surrey-based mother Elena Kim was the first person in the UK to undergo the Rafaelo procedure, which cost her an estimated £1,943.

“I was expecting pain but there wasn’t any,” she explained. “When the sedation wore off, I was so comfortable that I even asked if the procedure had been done. Now I can concentrate on my family and living life to the full again.”

Dharmistha Patel, a mother of two from Brighton, also had the Rafaelo procedure done. She had suffered from haemorrhoids for years and was in the process of arranging to have another treatment done when she stumbled across Rafaelo and opted for it instead.

“I had it done with local anaesthetic,” she said: “I couldn’t feel anything except a slightly warm sensation.

“It was over inside ten minutes and I left hospital an hour later, feeling no pain at all. The next morning I told the consultant it felt like a dream — no pain, no bleeding, nothing. It was the first time in 20 years that I’d felt like this.

“I’m back doing yoga, Pilates and lots of gym classes. I can also lift anything heavy and I’m not in discomfort at all.”

Nick West explained that the Rafaelo procedure (pioneered in Poland and Belgium) uses radiofrequency energy to essentially ‘burn’ haemorrhoids away. The technology is also used to cauterise varicose veins and help manage lung and liver cancer.

Mr West explained: “The main advantage is that Rafaelo doesn’t require a general anaesthetic, can be performed as a day-case procedure and patients can get back to their normal lives much faster.”

The Spire website describes the process in more detail:

“Using the safe and established technology of radio-frequency ablation, the Rafaelo procedure is performed as a short day-case procedure. It does not require a general anaesthetic and you will be able to return to your normal daily activities immediately after treatment. The Rafaelo procedure is designed to treat haemorrhoid grades 1–3. Some grade 4 haemorrhoids may be reduced but it is unlikely that they will not reach a complete resolution, which often will require surgery.”

As with all new procedures, there are of course some associated risks involved. Private Clinic state that: “The potential risks or side effects of the Rafaelo procedure includes some possible discomfort after the procedure, small amount of discharge, recurrence of symptoms, infection of the treatment area and minor bleeding within the first couple of weeks post-procedure.” Of course, as with all anal surgery, there is the slight risk of post-op pain and bleeding but this is rare.

When asked if the procedure hurts, they go on to explain that there could be some discomfort and a sharp scratch at the time when the anaesthetic is injected, but all pain subsides once it kicks in. Some patients can be given a sedative to help them relax.

Consultant colo-rectal surgeon at the Western Sussex Hospitals NHS Foundation Trust, Neil Cripps, says: “Rafaelo sounds as if it will be of benefit for haemorrhoids that bleed and prolapse, but don’t have large elements outside the anal canal.

“Any effective procedure that doesn’t involve a general anaesthetic and allows a patient to get on with their life more quickly has to be a significant advance.

“Like any new procedure, we need more clinical data before we can make any scientifically based claims, but it seems to be a promising new development.”

Mark Whiteley, a vascular surgeon at Whiteley Clinic, adds: “The early results from Rafaelo appear to be very good.

“It will be interesting to see how much improvement it can make to patients long term compared with traditional methods. I suspect the results will be good and patient satisfaction will be high.”

Six ways to help cope with haemorrhoids

Haemorrhoids are a very common problem for many around the world. They occur when veins in the rectum and anus swell, creating itchy, painful lumps which can go on to bleed if left unchecked. They can appear internally (rectum) or externally (anus).

Those who are obese, pregnant, lead a sedentary lifestyle or already suffer from other digestive disorders such as inflammatory bowel disease (IBD) are more at risk from getting haemorrhoids, as are those who are older. Haemorrhoids are bothersome and can seem to last forever for those suffering from them. However, there are a number of approaches which can help those with haemorrhoids cope until the condition has cleared up.

 

  1. Try a different position on the toilet

The way in which you sit on the toilet is rarely something you’ll spend much time thinking about… until you have haemorrhoids, or another condition affecting the anus. Try raising your feet up when seated on the toilet – you can use a small stool or pile of thick books to do this. When your knees are raised higher than your hips, your stool has an easier passage out of your body as your rectum is at a different angle. It’s also a good idea to avoid staying seated on the toilet for long periods of time, especially if you’re constipated. Leave your smartphone or magazine behind when you use the loo, and if nothing’s happening after a few minutes, don’t stick around. Trying to force a bowel movement when you’re constipated is one of the best ways to make your haemorrhoids worse.

 

  1. Make bowel movements easier on yourself

The easier it is to pass a bowel movement, the less strain your rectal and anal veins will be under, giving your body a chance to heal. Consume plenty of high-fibre foods and drink as much water as you can to soften your stool. You should aim to drink around eight large glasses of water every day to stay hydrated, and it’s a good idea to avoid coffee and alcohol when you have haemorrhoids as these can dehydrate you and make your stool harder. To lubricate your stool, try mixing some mineral oil (about a tablespoon-full) with a glass of prune juice, but don’t overdo it.

 

  1. Keep your anal region clean and dry

Keeping your anus clean and dry is vital, especially when you have haemorrhoids. Any excess moisture or dirt can cause increased irritation or even infection, so take the time to clean thoroughly after every bowel movement and pat yourself completely dry afterwards. You can also purchase an irrigation bottle from the local pharmacy (or simply use a squeezable bottle) to help wash down your anus after you use the toilet. Always use a moist toilette or an unscented wipe to clean and dry your anus, and never rub the area as this will only cause yet more irritation – abrasion should be avoided at all costs.

 

You can also try dabbing certain gels or ointments onto the haemorrhoid to help soothe any itchiness or pain when you’re cleaning your anal region. Aloe vera, coconut oil and vitamin E are all excellent moisturisers and can help reduce inflammation and swelling.

 

  1. Loosen things up inside

If your stool remains hard and uncomfortable, you can try cleaning out your rectum using a douche ball or enema bag, which can be bought from the local pharmacy. A douche introduces a stream of warm water into certain cavities in the body for hygienic or medical reasons. They’re usually used to flush out the vagina, but are also effective at clearing the rectum. A douche bag is simply the piece of equipment that holds the fluid used in douching.

An enema, similarly, “is the introduction of liquid, most often mineral oil, through the anus and into the large intestine. An enema may be given to treat constipation, to administer medication or barium, or as part of the procedure to empty the contents of the bowel before a test (such as​ a colonoscopy). Enemas may also sometimes be given before surgery on the abdomen or during a pregnant woman’s labour, but this is no longer common.” [link: https://www.verywellhealth.com/what-is-an-enema-1942425].

Douches and enemas should be administered with great care, and only water-based lubricants should be used as other lotions or creams can cause further irritation. Give any enemas or douche bags or balls a thorough clean afterwards to avoid infection, or simply throw them out.

 

  1. Take steps to reduce swelling and inflammation

Try using a cold or warm compress to bring down swelling around the anal region – this can give you some relief from haemorrhoid discomfort and itchiness. Always ensure that cold compresses (usually made with an ice pack or frozen bag of peas) is covered completely with a towel, as placing them directly onto your skin can cause significant injury.

You can also try using a Sitz bath, which “normally comes as a plastic kit that can be fitted to a standard toilet. It normally consists of a plastic bag, attached to a long tube, leading to a shallow plastic basin. The bag is filled with warm water, and this used to fill the plastic basin. The basin is larger than the toilet seat. It is placed underneath and is securely attached.” [https://www.medicalnewstoday.com/articles/312033.php].

A Sitz bath can help reduce swelling and pain in the region where haemorrhoids have appeared. As with a douche, take care to clean a Sitz bath thoroughly after usage to avoid passing on any infection.

 

  1. Adjust your sitting style

Finally, if you often sit on a hard or rough surface, try using a cushion or pillow to make yourself more comfortable. The harder the surface, the more pressure that will be exerted on your anus and rectum, making haemorrhoids more difficult to cope with. As with toilet usage, try to avoid sitting for long periods of time – get up and take a quick walk at work, and don’t be embarrassed to bring your cushion to the office with you.

Haemorrhoids can be hard to cope with, so do all you can to make things easier for yourself while you have them.

 

Prolapsed haemorrhoids

Haemorrhoids appear when veins in the rectum and anus come under strain and swell, producing lumps that can be itchy, painful, and can even bleed in certain circumstances. Haemorrhoids can be internal or external.

 

Prolapsed haemorrhoids

When an internal haemorrhoid in the anus bulges out into the rectum it becomes a prolapsed haemorrhoid. These can be very painful.

While internal haemorrhoids form within the rectum and push their way outside the anus, external haemorrhoids appear on the anus directly and can also prolapse. In both instances, prolapsed haemorrhoids can be alarming for those who suffer from them.

Internal haemorrhoids are graded as follows: 1) No prolapse; 2) Prolapse that is self-retreating; 3) Prolapse that can be pushed back into the rectum, 4) Prolapse that can’t be pushed back in. Grade 4 prolapsed haemorrhoids are, unsurprisingly, the most painful for sufferers.

 

How to know if you have a prolapsed haemorrhoid

A prolapsed haemorrhoid manifests itself as a lump (or several lumps) around the anal region which only appear if there is substantial prolapse. A prolapsed haemorrhoid will also be significantly more painful than a haemorrhoid which has not prolapsed. In some instances, prolapsed haemorrhoids can be pushed back through the anus into the rectum, though this is only a temporary measure.

Prolapsed haemorrhoids are often most painful when the sufferer is sitting and exerting more pressure on the anus. They will also hurt when the sufferer passes stool, or if the haemorrhoid becomes thrombosed (when a blood clot forms inside the haemorrhoid). Thrombosed haemorrhoids often need to be dealt with by a medical professional, and may require a specific treatment.

 

Why do haemorrhoids become prolapsed?

Haemorrhoids become prolapsed when the connective tissue holding them to the rectal wall become weakened, causing it to elongate and extend through the anus. Added strain on the haemorrhoid (during bouts of constipation or diarrhoea) can weaken the tissue and loosen its grip, causing it to prolapse. Other factors around prolapsed haemorrhoids include obesity (excessive and unrelenting strain placed on the rectum causes haemorrhoids to form and then prolapse) and the use of cigarettes or excessive alcohol consumption (both of which can weaken rectal veins and increase the risk of prolapse). In addition, pregnant women are also more at risk of getting haemorrhoids and having them prolapse if left unseen-to.

 

How to know if a haemorrhoid hasn’t prolapsed yet

Internal haemorrhoids produce no real symptoms, so you may not be aware you have them at all. In certain circumstances you may experience some bleeding from within the rectum, which will appear bright red on toilet paper after you use the loo. External haemorrhoids, on the other hand, are likely to feel itchy and possibly even painful before they’ve prolapsed.

 

Dealing with a prolapsed haemorrhoid yourself

Haemorrhoids usually clear up on their own after a short time, but they may remain itchy and uncomfortable during the time they’re present in your body. However, there are several approaches you can take to deal with them until they’ve gone.

First, examine your diet and see how you can change it to reduce strain on your body, particularly the rectal and anal regions. Increase your intake of high-fibre foods such as fresh fruit, vegetables and whole grains – this can help make your stool softer and, consequently, much easier to pass. Harder stool equates to increased strain on rectal veins, which can cause haemorrhoids or make them prolapse. You should also drink more water and less coffee when you have haemorrhoids.

Next, try a Sitz bath or a cold or warm compress to help reduce swelling around the anus. Reducing swelling and inflammation can lead to faster recovery from haemorrhoids, whether they’re prolapsed or not. It’s also a good idea to pat yourself dry after cleaning the affected area rather than rubbing it, as abrasion may make things worse.

Finally, you can purchase products from your local pharmacy to help treat haemorrhoids. Suppositories, creams and ointments can lower irritation, swelling and inflammation – just avoid anything that’s perfumed.

 

What to do if home remedies don’t work

In many cases, home remedies are enough to deal with prolapsed haemorrhoids, or at least make them manageable. Sometimes, however, extra attention is required. You should always see a doctor immediately if you suspect you have a prolapsed haemorrhoid. If a haemorrhoid begins to bleed or is excessively painful, the sufferer may need to see a doctor a second time for more substantial treatment. Prolapsed haemorrhoids are usually treated by physicians in the same way normal haemorrhoids are, and only a small percentage of them ever require surgical treatment.

Haemorrhoids often clear up of their own accord, and can do so fairly quickly. However, sometimes they persist no matter what treatment has been administered, and you may need to see a specialist. A proctologist (a medical professional specialising in problems with the rectum and anus) or a gastroenterologist (focusing on the stomach and intestines) would be the most likely people your GP would refer you to.

There are many treatments available for haemorrhoids, surgical and non-surgical, the latest being a radio frequency based treatment called The Rafaelo Procedure. It might be that your GP is not familiar with the treatment but check out the Rafaelo website to see where your nearest clinic is.

In all cases, as soon as you feel a lump in your anus, you should consult your doctor immediately. While a lump is often symptomatic of a prolapsed or external haemorrhoid, it can also be a sign of a much more serious condition, and should be addressed as soon as possible.

 

What will the doctor do during the examination?

If a haemorrhoid is indeed prolapsed, the doctor will be able to see it easily and diagnose the problem there and then. In some cases, though, a digital examination may be required, in which case the doctor will insert a finger (gloved and lubricated, of course) into the anus and rectum to check for haemorrhoids. This may feel invasive, but is a requirement for diagnosis.

 

Recovering from prolapsed haemorrhoids

In the wake of a haemorrhoid examination or procedure, bowel movements may feel more uncomfortable than usual as the anal region has experienced increased strain or abrasion. Your doctor will most likely require you to pass stool within the next 48 hours and may give you a suppository to help the process along. Several weeks of recovery may be required after a surgical procedure for prolapsed haemorrhoids.

What is the latest treatment for haemorrhoids?

If you suffer from irregular albeit repeating, symptoms of haemorrhoids, such as itching, bleeding, pain and/or mucus discharge, your GP will likely suggest a change in your diet (an increase in fibre intake) in order to put less pressure on your sphincter and surrounding tissue when trying to pass stools. This will reduce the likelihood of the blood vessels and anal tissue from becoming inflamed and swelling. In the meantime, he/she might suggest the use of topical creams which will reduce the symptoms in the interim.

Apart from off-the-shelf creams and lotions which are generally designed to temporarily quell the symptoms of haemorrhoids, there are a range of non-surgical and surgical treatments designed for more permanent relief of symptoms and the tissue mass associated with haemorrhoids, otherwise known as piles.

Historically, haemorrhoids were removed by way of a surgical procedure called Haemorrhoidectomy (Milligan Morgan method). This was, and is still today, a very invasive procedure, carried out under general anaesthetic in the operating theatre. The haemorrhoid is identified using a proctoscope and then is physically cut with a scalpel and scissors, leaving an open wound. This wound will heal over time leaving scarred tissue on the inside of the anal passage where the pile once was. The healing process can take several weeks, and is often very painful, particularly when attempting to pass stools during that period, and many people are forced to take 2-3 weeks off work to allow its recovery.

Statistically, the haemorrhoidectomy will be successful in 90% of cases, but it is not without the endurance of significant pain. Despite newer techniques having been adopted over the past 20 years, and despite the pain it causes to the patient, the Milligan Morgan technique still remains the gold standard for the removal of grade 3 and grade 4 haemorrhoids. There are numerous other haemorroidectomy techniques, such as The clamp and cautery haemorrhoidectomy, the open haemorrhoidectomy, closed haemorrhoidectomy, submucosal haemorrhoidectomy, whitehead circumferential haemorrhoidectomy, stapled haemorrhoidectomy, pile suture’ method, the bipolar diathermy haemorrhoidectomy, and the ligasure haemorrhoidectomy.

There are a number of non-surgical options however and these have developed over time.

Rubber Band Ligation

A very common procedure usually performed in an outpatient or day-case setting, where a band is placed tightly around the pile so to cut off its blood supply and cause it to fall away. This is a often used for the bleeding grade 1, 2 and 3 haemorrhoids but generally has a 30-50% recurrence rate meaning that by many it is considered to be a temporary fix and will often require repeat procedures.

Injection Sclerotherapy

A quantity of 1-3 mL of a sclerosing agent (5% phenol in almond or Arachis oil, sodium morrhuate or quinine urea) is injected into the submucosa of each haemorrhoid. The objective is to cause thrombosis of the vessels and promote fibrosis, which retracts the prolapse. This is still commonly used although, again the recurrence rate is in the region of 30% and is likely to require repeat procedures.

Haemorrhoid Artery Ligation (HALO)

Also known as THD, the surgeon can identify and ligate the haemorrhoidal arteries, using an embedded doppler, by placing a suture around them. This procedure is generally undertaken under general anaesthetic and can cause post operative pain. It is widely used on Grade 2 and Grade 3 haemorrhoids although in order for it to be effective, it is often combined with a mucopexy in order to discard the prolapsing element of the pile. Both HALO and THD, effectively the same technique but manufactured by two different companies, are said to be ineffective on large prolapsing Grade 4 piles. Both are said to have a 30% failure rate requiring repeat or alternative procedures to be carried out if it fails.

RAFAELO PROCEDURE (latest)

Utilising the safe and reliable technology known as radio frequency, the Rafaelo Procedure is the latest treatment available for the treatment of all grades of internal haemorrhoids. Carried out under local anaesthetic, with or without sedation to relax the patient, a probe is used to emit radio frequency energy (in the form of heat) into the pile causing the feeding blood vessel to close, the pile tissue to shrink and eventually fall away. This is carried out as a day case, it takes only a few minutes to carry out, with minimal pain during and post procedure, after which the patient is able to carry on with their normal daily activities without and significant downtime required. Current studies suggest that this is effective in circa 90% of cases and, since its launch in the UK, over 1,200 treatments have been carried out, with many more abroad.

Risks of anal surgery/procedures

All surgical and non-surgical treatments carried out in the anal passage carry the same risks including post-operative pain or discomfort, bleeding, infection, thrombosis and, in very few cases, incontinence. Your surgeon will explain the options to you and the corresponding risks of complication and recurrence. Make sure you are fully aware of the pro’s and con’s of your preferred treatment before embarking upon it.

Costs of Haemorrhoidal treatment

A variety of treatment options are offered in the UK on the NHS, but not all. The NHS has recently published a list of conditions which they are limiting treatment provision of, and one of those is haemorrhoidal treatment. Privately, either insured or self-pay, all treatments are available depending on where you live or are prepared to travel to. The latest treatments, such as The Rafaelo Procedure, are available in the majority of Spire Healthcare facilities across the UK. but also from many other organisations within the BMI, Ramsay, Nuffield and independent hospital groups. To find out where The Rafaelo Procedure can be performed, click here. Treatment costs range from a few hundred pounds for Banding and Sclerotherapy to circa £2,000+ for HALO and Rafaelo and up to £3,500 for Haemorroidectomies. When considering which treatment to opt for, if cost is an issue, take account of the likely recurrence rates for each and hence how many times it might need to be repeated.  Private medical insurers, such as BUPA, CIGNA and WPA cover Rafaelo and other procedures but do check with them first before committing to the treatment.

 

How long do haemorrhoids last?

This is another very common question regarding haemorrhoids – it is, however, also one of the most difficult to answer.

The severity and duration of haemorrhoids is largely dependent on the individual in question, especially in terms of their health, age, gender and lifestyle. For some, haemorrhoids can largely be dealt with within a matter of days or weeks; others continue to suffer for much longer and often require surgery before the problem is fully rectified.

The type of haemorrhoid that the individual is suffering from must also be considered. Internal haemorrhoids often go away of their own accord and sometime require no treatment at all, whereas external haemorrhoids cause much greater discomfort and need more attention as a result. Whether or not the haemorrhoids are prolapsed or thrombosed is also something that should be factored in when thinking about duration.

 

  • So, how long do haemorrhoids last?

The simple answer is, it all depends on the individual. Unlike many other conditions, there is no clear timeline in terms of haemorrhoid recovery. Small haemorrhoids can clear up in no time at all, while larger haemorrhoids may take much longer. If haemorrhoids continue to endure, the sufferer should always seek medical advice.

Of course, you can increase your chances of both getting and keeping haemorrhoids for longer if you’re overweight, pregnant, spend too long on the toilet or sitting down in general, don’t eat enough fibre or drink enough water, don’t get enough exercise, engage in anal intercourse, have chronic bowel movement issues, or use too many laxatives or supplements. Older people are also more at risk from haemorrhoids, though anyone can realistically get them.

A poor diet or a sedentary lifestyle in particular can make recovery from haemorrhoids even more difficult.

 

  • Ditch the unhealthy diet

What you eat and drink (and in what quantity) is a major contributing factor to your likelihood of getting haemorrhoids and your ability to recover from them. If you eat a lot of food containing fat or food that’s heavily processed, you won’t help your cause; consuming low amounts of fibre, such as fruit and vegetables, and drinking too much caffeine can increase the risk of haemorrhoids occurring as they will make your stool harder and therefore more difficult to pass.

Simply eating foods like fruits, vegetables and whole grains can help soften your stool and make bowel movements easier, putting less strain on your rectal veins, helping avoid more inflammation or irritation. The antioxidants contained within high-fibre foods can also strengthen your blood vessels and help prevent haemorrhoids from forming again.

You should always aim to stay hydrated as much as possible, as this will again help soften your stool and make bowel movements easier. Try bringing a water bottle with you to work or have one nearby when you’re at home – the more you drink, the easier your time on the toilet will be. On the flip side, smoking too many cigarettes and drinking too much alcohol can make the appearance of haemorrhoids more likely, so cut back on these if you can.

If constipation continues to plague you and stands in the way of your recovery from haemorrhoids, you can also ask your doctor for stool softeners to make things more straightforward, though these should just be a temporary measure.

 

  • Lifestyle

If you have haemorrhoids, they’re likely to stick around longer if you spend excessive amounts of time sitting and if you don’t get enough exercise on a daily basis. Regular exercise can help regulate your bowel movements – you can also try keeping to a bowel movement schedule to help avoid holding it in or trying to force it.

Being overweight is also a contributing factor to delayed recovery from haemorrhoids. Try to keep your weight down to avoid getting haemorrhoids in the first place, and stay away from foods that will only exacerbate the problem further if you do begin to suffer from them. The less weight you carry, the less pressure there will be on your rectal and anal veins.

 

  •  What to do while suffering from haemorrhoids

Haemorrhoids are very treatable, and can be tackled through home remedies and by using products purchased from the local pharmacy. Home remedies include warm and cold compresses, while you can purchase pharmacy products such as sitz baths, herbal remedies, wipes and ointments. Most haemorrhoid treatments contain anti-sceptics and anti-inflammatories to help with your recovery, though you should always avoid anything that’d scented as these products can cause further irritation or pain.

Your doctor can also prescribe treatments to help your recovery go faster, and may recommend more aggressive approaches such as surgery if your haemorrhoids fail to go away after a while, or if you experience increased pain or bleeding.

If you do have haemorrhoids, try to avoid sitting for too long, especially on very hard or rough surfaces. Use the toilet as soon as you feel the need to, and don’t sit on it any longer than is necessary. Leave your smartphone elsewhere when visiting the bathroom to avoid distracting yourself from the task at hand, and take care when cleaning your anus (gently wipe; pat dry rather than rub).

If treated correctly and consistently, haemorrhoids often vanish within a fortnight. If you work hard to improve your diet, continue exercising and avoid sitting too much, you can regulate your bowel movements and soften your stool, decreasing strain on your rectal veins and allowing the region to heal up quickly.

For some people, haemorrhoids take longer to heal, irrespective of whether or not they make changes to their diet or lifestyle. Be prepared to be patient while your body works to recover from this itchy, painful condition.

 

  • Can haemorrhoids come back again?

Unfortunately, yes. There is little research out there on the recurrence rate of haemorrhoids, but they can certainly return under the right circumstances. Studies do suggest that those who have their haemorrhoids removed through surgery are much less likely to see them return than those who opt for home remedies and treatments.

Can haemorrhoids kill you?

Haemorrhoids occur when blood vessels in the rectum and anus come under pressure and swell, causing irritation and inflammation. They can appear inside the rectum as internal haemorrhoids or under the skin around the anus as external haemorrhoids. The symptoms of haemorrhoids can be very disconcerting, and a common question regarding them crops up time and again – can haemorrhoids actually kill you?

 

Why haemorrhoid symptoms are alarming

Haemorrhoids are extremely common, affecting millions around the world every year. The likelihood of suffering from them is increased if you’re overweight, have an unhealthy diet, spend a lot of time sitting, or are pregnant. Your chance of getting haemorrhoids also increases as you get older.

Haemorrhoids symptoms can be upsetting for those who have never experienced them before, either personally or through the experience of someone else. Common symptoms accompanying haemorrhoids include itchiness around the anus, pain during bowel movements or when shifting sitting positions, small bumps around the anal opening, bleeding or blood in the stool, and discharge of mucus or faecal matter during a bowel movement.

Anyone would be concerned if their body began exhibiting these symptoms, no matter how level-headed they might be. It’s no wonder, then, that so many individuals panic when haemorrhoids symptoms first manifest themselves. They are, however, not generally considered to be life-threatening.

 

Can haemorrhoids ever become fatal?

While haemorrhoids usually clear up quickly and often don’t require the input of a medical professional, some issues can arise that can cause dangerous complications.

In the case of internal haemorrhoids, prolapsing can occur, when they push through the rectum into the anus. This can often be accompanied by significant bleeding, which is always an alarming symptom. Prolapsed haemorrhoids are not life-threatening, but problems can occur when they prolapse extensively outside of the anal opening and become visible – in this instance, they will require treatment to rectify the issue before it progresses into a rectal prolapse. According to ASCRS [link: https://www.fascrs.org/patients/disease-condition/rectal-prolapse-0]:

“Rectal prolapse is a condition in which the rectum (the last part of the large intestine) loses the normal attachments that keep it fixed inside the body, allowing it to slide out through the anal opening, turning it “inside out.” Rectal prolapse affects mostly adults, but women ages 50 and older have six times the risk as men. It can be embarrassing and often has a negative effect on a patient’s quality of life.”

While haemorrhoids don’t necessarily cause rectal prolapses directly, they can contribute to the likelihood of them occurring as they are often associated with chronic constipation, which is a key factor in haemorrhoids flaring up.

External haemorrhoids can become complicated and problematic when thrombosis occurs. In this case, a blood clot forms and becomes stuck inside the swollen and inflamed veins in the anal region. Very Well Health [link: https://www.verywellhealth.com/thrombosed-hemorrhoid-1945070] describes them thusly:

“Thrombosed haemorrhoids are typically external haemorrhoids that have no blood flow due to a blood clot in the vein. Thrombosed haemorrhoids are not considered to be dangerous, yet they can be quite painful. In most cases, the blood clot is eventually reabsorbed by the body and the symptoms resolve themselves.”

Thrombosed haemorrhoids manifest as a single pile or circle of piles, which turn bluish due to trapped blood in the vein. Unlike normal haemorrhoids, which are irritating and uncomfortable without being overly painful, thrombosed haemorrhoids are very painful and require treatment from a doctor, who will ensure that the clot contained within the haemorrhoid is dealt with before it can move to a more dangerous part of the body through the bloodstream.

A small number of serious complications can arise as a result of haemorrhoids occurring. According to Medical News Today [link: https://www.medicalnewstoday.com/articles/73938.php], these include:

 

Strangulated haemorrhoids: If the blood supply to the haemorrhoid is cut off, it may become strangulated. This can cause significant pain.

Anaemia: Significant, chronic blood loss from haemorrhoids can lead to anaemia. This occurs when there are not enough red blood cells in a person’s circulation.

Blood clots: Sometimes, blood may clot in the anus, which can be painful. The area will swell and become inflamed.”

While these conditions aren’t necessarily fatal, they can cause significant pain and discomfort, and certainly require medical action.

 

What happens if haemorrhoids don’t stop bleeding?

If you find bright red blood in your stool, you should speak to your doctor immediately as the symptom may not stem from haemorrhoids. Your physician will likely recommend a series of tests to determine the exact cause of your rectal bleeding, and will suggest further action if required.

 

Haemorrhoids will generally stop bleeding very quickly. They may also bleed profusely in the case of a ruptured thrombosed haemorrhoid, but even then the bleeding will subside after a short time. If your rectal bleeding does not stop, it could be symptomatic of another, more serious issue such as an anal fissure, anal or colon cancer, angiodysplasia, crohn’s disease, diverticulosis, proctitis, or solitary rectal ulcer syndrome.

Do not, however, attempt to self-diagnose if blood appears in your stool – leave that to the doctor.

 

When will more extreme treatment be required?

Haemorrhoids are very treatable, but if left unchecked, they can progress into more serious conditions. Prolapsed or thrombosed haemorrhoids can have a detrimental impact on your daily routine and make life more difficult than it needs to be. In this case, a more aggressive treatment approach will be required to resolve the issue.

In the event that haemorrhoids become particularly large or painful, a variety of surgical options are available to help deal with them. Rubber band ligation, sclerotherapy and haemorrhoidectomy are just three of several methods that can help remove haemorrhoids completely and restore a patient’s health and happiness.

 

 Conclusion

Haemorrhoids can cause a great deal of irritation, discomfort and pain. Symptoms associated with them can be alarming, especially in the case of rectal bleeding or thrombosed haemorrhoids. However, it’s highly unlikely that haemorrhoids will result in death, unless another condition flares up simultaneously.

Always consult your doctor immediately if you’re concerned about potential haemorrhoids, or haemorrhoid symptoms that persist even after treatment. Haemorrhoids are not fatal, but they share symptoms with a number of other conditions that are life-threatening.

What not to do when you have haemorrhoids

Haemorrhoids are a common problem that many people suffer from each year – they are, however, not usually a serious issue and can be treated at home or by a doctor. Unfortunately, many people frequently make their condition worse by doing things that only aggravate their haemorrhoids further, sometimes resulting in more extensive treatment being required.

Here are a few examples of what NOT to do when you have haemorrhoids.

 

  1. Try to ‘hold it in’

One of the worst things you can do when you have haemorrhoids is not going to the toilet the moment nature calls. In fairness, passing stool during a period of haemorrhoid suffering can be painful, and you may try putting off visiting the lavatory as long as possible. However, the more you resist your body’s desire to make a bowel movement, the more your rectal and anal veins will come under pressure, further aggravating your haemorrhoids. Whatever you do, don’t ‘hold it’ any longer than you absolutely have to.

 

  1. Have high stress levels

Stress can lead to more serious mental health problems, such as depression, which will only make your haemorrhoid problem worse and deter you from actively attempting to treat them. No matter what’s causing your stress or anxiety, whether it’s your job, home life or financial situation, you should do your best to de-stress as much and as often as possible. Take a break, get some exercise, do something that you enjoy. Whatever you need to do to bring your stress or anxiety levels down, do it – it will make a difference in your recovery from haemorrhoids, and will have a positive impact on your outlook on life.

 

  1. Sit for long periods of time

This is a common reason for haemorrhoids appearing in the first place. If you work in an office where you spend large amounts of time sitting at a desk, or if you stay seated a lot during your free time (whether you’re reading, watching TV, etc), you can develop haemorrhoids. And if you continue to do so when you have haemorrhoids, you’ll most likely make them worse. As with trying to delay a bowel movement, sitting for excessive amounts of time will put added pressure on your anal veins and exacerbate your haemorrhoids. Get up from your chair and take a quick walk every so often. Keep the pressure off those haemorrhoids when you can.

 

  1. Drink too much caffeine

If you’re a heavy coffee drinker, you may have to seriously cut back if you develop haemorrhoids. Caffeine causes dehydration and can lead to stomach problems – it’s also highly likely to cause constipation if you drink too much of it, which will have a massively detrimental effect on your recovery from haemorrhoids. Cut down on the coffee and stayed as hydrated as you can.

 

  1. Have poor hygiene

Maintaining good hygiene is something everyone should do regardless of whether or not they have haemorrhoids, but extra care should be taken to ensure your anal region is clean and dry when you’re suffering from piles. Keep your anal area clean and pat it dry rather than rub, as the abrasion can irritate external haemorrhoids further. A good level of hygiene is a must in your recovery from haemorrhoids.

 

  1. Lift heavy objects

You should continue exercising if you develop haemorrhoids, but be careful with how you go about burning those calories. Lifting weights or other heavy objects in your day-to-day routine can increase pressure on your rectum and anus, worsening your haemorrhoids. If you have external or thrombosed haemorrhoids, lifting heavy items can cause them to burst or become prolapsed. Be sensible in regard to what you lift, and stick with light exercise when you can.

 

  1. Use scented products

Many products, such as creams or ointments, contain chemicals which can cause irritation to sensitive skin – in some cases, they can even cause a great deal of pain. If you want to use creams or wipes to keep your anal region clean while you have haemorrhoids, be sure to check whether or not the products in question are scented or unscented before making a purchase – you could save yourself a great deal of irritation or pain by doing so.

 

  1. Turn a blind eye to your bowel movements and stool

While what you do on the toilet isn’t usually an enjoyable topic of conversation of self-reflection, don’t ignore what’s happening when you use the loo. If you have haemorrhoids and begin to experience constipation or diarrhoea, your problems could seriously worsen as your rectum and anus are put under added strain. Constipation is particularly detrimental to your recovery from piles as it can cause internal haemorrhoids to become external, or thrombosed haemorrhoids to rupture and bleed. Take the time to check exactly what you’re eating during the course of each day, and try to increase your intake of high-fibre foods and water. If your bowel movements continue to fluctuate even after dietary changes have been made, consult your doctor, who can prescribe something to help ease your discomfort.

 

  1. Sit on hard surfaces for extended periods of time

While the temperature of your sitting surface has no real bearing on your haemorrhoids, the pliability of it does. If your work chair is quite hard, use a cushion to relieve the pressure on your anus; similarly, try to avoid sitting on hard floors or ground when you have haemorrhoids, and if you must sit, take a quick break when you can.

 

  1. Use your phone when on the toilet

This sounds a bit obvious, but many people get sucked into doing it every day. When you go to the toilet, avoid sitting on it for extended periods of time scrolling through your social media news feeds or watching YouTube videos – you’ll only increase the strain on your anus, which will in turn worsen your haemorrhoids. Leave your phone behind when you visit the loo, or use a timer to remind you when to finish.

Common questions about Haemorrhoids

Haemorrhoids are a common problem for many around the world every year. They flare up quickly and can cause a great deal of discomfort, but they’re not life-threatening and normally clear up of their own accord. The symptoms they produce can be alarming, however.

So with haemorrhoid sufferers constantly searching for answers online to put their minds at ease, let’s take a look at some of the most frequently-asked questions concerning them.

 

1. What exactly are haemorrhoids?

Haemorrhoids occur when veins in the rectum or anus swell under pressure and become inflamed. They are very itchy and can cause a great deal of discomfort for those suffering from them. In certain cases they can also bleed, prolapse or become thrombosed. They can appear inside and outside the body.

 

2. How many different kinds of haemorrhoids are there?

There are several varieties of haemorrhoid, but all occur around the rectum or anal regions. Internal haemorrhoids appear inside the anus and are not visible to an examiner. They may, however, develop further to become external haemorrhoids that are visible beneath the skin of the anus. External haemorrhoids can prolapse and hang down from the anus visibly, creating a new problem for sufferers. Haemorrhoids can also thrombose (clot) and burst if they become too full of blood. You can suffer from both internal and external haemorrhoids simultaneously.

 

3. How common are haemorrhoids?

Very common indeed. It’s likely that at least one in twenty people will suffer from haemorrhoids are some point in their lives, and that chance only increases as people get older (roughly fifty per cent of adults aged over fifty years old are likely to get haemorrhoids). However, in spite of how common they are, haemorrhoids are not life-threatening and are not considered a ‘serious’ issue by most medical professionals, unless they fail to heal after treatment.

 

4. Does anything increase your chances of getting haemorrhoids?

There are several things that can increase your chance of getting haemorrhoids, although anyone can contract them at any point, no matter what preventative measures they put in place. If you’re overweight or spend significant amounts of time sitting (whether that’s at work or at home), you’ll put added pressure on your anal region and increase the chance of getting haemorrhoids. Older people and pregnant women also have an increased chance of haemorrhoids occurring in their rectum or anus, and those suffering from diarrhoea and constipation are also more likely to get them as more strain is placed on their rectal veins.

 

5. Can you avoid getting haemorrhoids?

While anyone can get haemorrhoids are any time, there are a few things you can do to reduce your chances of suffering from them. Start by avoiding sitting for too long (take a quick walk at work) and get regular exercise. Consume as much high-fibre food as you can, especially fresh fruit and vegetables and anything made from whole grains. You should also stay hydrated at all times by drinking plenty of water. If you do become constipated, you can soften your stool further with softeners or laxatives, though these should only be used as a temporary measure.

 

6. What symptoms accompany haemorrhoids?

People with haemorrhoids will normally experience excessive itching around the anal region, and may also feel hard lumps under the skin. Bowel movements may become painful and blood may appear in the stool. Sufferers will experience a lot of discomfort when sitting or cleaning their anus. If blood appears in your stool, you should always consult your doctor immediately in case it’s a symptom of something more serious than haemorrhoids.

 

7. What can I buy from the pharmacy to treat haemorrhoids?

There are a number of effective products available at your local pharmacy to help tackle a haemorrhoid problem. You can purchase ointments, sprays, creams and other suppositories to help relieve your haemorrhoid symptoms, as long as they are unscented. Products for haemorrhoid relief will likely contain anaesthetics or ingredients that help reduce swelling.

 

8. Are there any home remedies for haemorrhoids?

Yes, there are a few things you can try which can help relieve your haemorrhoid pain at home. Try using a warm compress with a towel soaked in hot water to reduce itchiness and pain around your anus; you can also use a cold compress (an ice pack wrapped in a towel) to tackle swelling, and alternating between both can increase the effectiveness overall. You can also use a Sitz bath to soak the region. Avoid wiping your anus with normal toilet paper while suffering from haemorrhoids – it’s best to use a moist paper toilet or wipe to gently clean the area before patting it dry (don’t rub it). Again, change your diet to help avoid constipation, which would only aggravate your symptoms further.

 

9. If I see the doctor, what procedures might he or she recommend?

In the event that home remedies and pharmacy-bought products don’t do the trick, it’s time to speak to your doctor. A variety of procedures are available to tackle haemorrhoids: your doctor may suggest a rubber band ligation, clot removal, sclerotherapy or coagulation, all of which can be completed under local anaesthetic in the outpatient surgery or doctor’s office.

The most common method for shrinking haemorrhoids is rubber band ligation, which works successfully for 75% of patients, although it is shown to have a recurrence rate of between 30% and 50%. It simply involves cutting off the blood supply to a haemorrhoid using a rubber band – after a few days pass, the haemorrhoid dies and drops off on its own. It can be quite painful and carries its own risks.

A sclerotherapy injection involves your doctor injecting a chemical into the haemorrhoid to shrink it down, after which time it will again just drop off by itself. Coagulation can also be used to stop blood flow to haemorrhoids using laser techniques or stapling.

The latest treatment for Haemorrhoids, using radio frequency ablation technology, is a walk in walk out option, carried out generally under local anaesthetic (with or without sedation) and it is done within a few minutes. Importantly, one can generally resume their daily activities almost straight away! It is known as The Rafaelo procedure. This is rapidly becoming the most sought after procedure in the UK, available from Glasgow down to Truro within 40+ private hospitals and at some NHS hospitals.

In the most extreme cases, a haemorrhoidectomy may be required to physically cut out someone of haemorrhoids. It is said to be effective up to 90% of the time, but is normally only used for larger haemorrhoids that prove problematic. It is generally carried out under general anaesthetic and is usually very painful for several weeks post-op, requiring a similar amount of time of work.

Haemorrhoid Myths

Most people have heard of haemorrhoids, and many may even have a fairly good understanding of what they actually are. They are, unfortunately, a very common problem around the world, with many individuals suffering from them – in fact, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) claim that 10.4 million people in the USA alone suffer from haemorrhoids each year.

However, a number of myths also exist around haemorrhoids that many people believe to be true. Some myths are trivial, but others can be troublesome, especially if they deter people from seeking the right medical treatment (only 1 in 3 people with haemorrhoids actually seek medical help).

Let’s take a look at just a few myths about haemorrhoids, some of which are true, and some of which are false:

 

  1. Only old people get haemorrhoids.

This isn’t true. While the risk of getting them does increase with age, younger people can also get haemorrhoids. If you strain excessively during a bowel movement or have chronic problems in regard to the passing of your stool, you can develop haemorrhoids in your rectal and anal regions.

 

  1. Everyone already has haemorrhoids.

Also not true. While we do all have veins in our rectum that can become swollen if put under too much strain, we don’t all already have haemorrhoids. However, a substantial number of people will suffer from them at some point in their lives, and no-one should be deterred from speaking to their doctor about it in order to receive medical help.

 

  1. Only unhealthy people get haemorrhoids

Unfortunately, as with many conditions, anyone can get haemorrhoids, no matter how healthy or unhealthy they are. Of course, eating a balanced diet and getting regular exercise can help reduce your chances of getting them.

 

  1. You can get haemorrhoids after sitting on surfaces that are very hot or very cold

Don’t place any stock in this one – haemorrhoids are not caused by sitting on very hot or cold surfaces. The temperature of your sitting surface, whether that’s your chair at work or a bench in the park, has no bearing whatsoever on whether or not you’ll develop haemorrhoids. It’s the length of time you spend seated which can affect your chances of getting them.

 

  1. Haemorrhoids can be caused by pregnancy

Actually, this one’s not far off. Up to a third of women may suffer from haemorrhoids at some point during their pregnancy as mounting pressure in the pelvic blood vessels can cause haemorrhoids to swell and even prolapse. As the womb expands, pressure on blood vessels increases, and haemorrhoids become more likely. Doctors can prescribe treatments to help relieve discomfort for pregnant mothers.

 

  1. You can develop haemorrhoids if you sit a lot as part of your job

Again, this one’s true. As mentioned before, the temperature of your sitting surface makes no difference to your likelihood of developing haemorrhoids, it’s the duration of your sitting that counts. If you work in an office, for instance, take time away from your desk to stretch your legs and have a break from staring at the screen. You’re entitled by law to have a few minutes’ rest every so often, so make the most of it. The more active you are, the less likely you’ll be to develop haemorrhoids.

 

  1. A balanced diet can reduce haemorrhoid symptoms

True. If you can avoid becoming constipated, your chance of developing haemorrhoids (or making them worse) can be greatly reduced. Get as much high-fibre food into your diet as possible, including fruit, vegetables and whole-wheat rice, and stay as hydrated as possible. It’s also important to get plenty of exercise and avoid increasing your stress levels. All of this will help you avoid constipation and diarrhoea, thus reducing the chance of haemorrhoids appearing in your rectum or anus.

 

  1. You should stop exercising if you develop haemorrhoids

Absolutely not. Regular exercise is good for your rectal veins, reducing the likelihood of you getting haemorrhoids; it’s also of great benefit to your colon, which makes passing stool much easier. Try going for a walk or a swim, or do a bit of yoga – all of these activities are light enough to avoid straining your system but effective enough to combat haemorrhoids. However, weight lifting can increase your risk of getting them, especially if your technique is inadequate.

 

  1. Haemorrhoids have no real cure or treatment

False – haemorrhoids are very treatable. If you develop them and are experiencing a lot of itching and discomfort, you can purchase treatments from your pharmacy to help you find some relief. There are also a number of home remedies available to treat haemorrhoids, many of which will cost you nothing at all. Of course, if you’re still experiencing pain from your haemorrhoids and home treatment isn’t working, speak to your doctor and have them prescribe you something to help with the pain. He or she may also point you in the direction of a specialist.

 

  1. Haemorrhoids can be caused by eating too much spicy food

It’s highly unlikely that this one’s true. The link between spicy or exotic foods and haemorrhoids has never been established. However, such foods can of course cause an upset stomach, which can lead to problems passing stool later on – this can in turn cause constipation, which is a major factor in haemorrhoid development.

 

  1. Anal bleeding is a symptom of haemorrhoids

Unfortunately, this is true. If your haemorrhoids begin to bleed, or if you have a thrombosed haemorrhoid that has burst, you will likely experience anal bleeding. Blood from haemorrhoid bleeding is bright red and may alarm some sufferers, but it can be treated fairly easily. Anal bleeding can be a sign of more serious conditions, though, so speak to your doctor if it starts to happen to you.

 

  1. Haemorrhoids can lead to cancer

Thankfully, this one isn’t true. Getting haemorrhoids does not mean that you’ll develop cancer as a result. However, both haemorrhoids and colon cancer share similar symptoms (such as bleeding from the rectum), so go see your doctor if you’re concerned.

Why do Haemorrhoids bleed and how can I stop it?

 

Haemorrhoids

Also known as piles, haemorrhoids occur when veins in your rectum or anus become inflamed and swell as result of increased pressure being exerted on them, usually when someone has constipation or diarrhoea. Sufferers can develop either internal (within the rectum) or external haemorrhoids (under the skin around the anus). All types of haemorrhoids are itchy and can become painful – they can also begin to bleed over time if left untreated. They are, however, not life-threatening and usually clear up on their own.

 

Bleeding haemorrhoids

Both internal and external haemorrhoids can start bleeding if the outer skin of the haemorrhoid lump becomes damaged due to excessive straining during a bowel movement. Thrombosed haemorrhoids can also rupture if they become too full. All haemorrhoid bleeding produces blood that appears bright red on a wipe or toilet paper, and can be quite alarming.

Haemorrhoids normally only bleed after they’ve been damaged or severely irritated, and will usually heal on their own. If, however, the bleeding continues for several days or has no obvious source, you should speak to your doctor immediately as a number of other more serious conditions can exhibit the same symptoms as haemorrhoids.

As previously mentioned, internal and external haemorrhoids can progress into thrombosed haemorrhoids, which occur when a blood clot appears within the vein, causing a lot of pain. If a thrombosed haemorrhoid becomes too full of blood it can burst, and will bleed profusely for a short time. The haemorrhoid will be very painful prior to bursting, but will settle down shortly after it has ruptured and produce a sensation of relief instead for the sufferer.

If bleeding continues for longer and is accompanied by ongoing pain, you may have a bleeding haemorrhoid instead of a burst thrombosed haemorrhoid. Bleeding can endure for up to several minutes but shouldn’t last longer than ten minutes. Further bowel movements may lead to more bleeding.

 

How to treat bleeding haemorrhoids at home

The first step in all home treatments for haemorrhoids is to cleanse the affected region. This can be achieved in a few simple ways.

First off, when cleaning the anal area after bleeding or a bowel movement, pat rather than wipe the region as too much abrasion can cause further irritation. A moistened paper towel or unscented cleansing wipe can be used when cleaning – don’t use anything perfumed or scented as this can also cause increased irritation to the sensitive skin in the anal region.

Next, try soaking the area in warm (not hot) water to gain some much-needed relief and further cleanse the region. You can do this in a normal bathtub or by using a sitz bath,  a basin which is placed over the toilet seat. Epsom salts can be added to the water to increase the comfort factor.

If you’re experiencing a lot of painful swelling as a result of haemorrhoids (whether they’ve bled or not), you can reduce it by using either a warm or cold compress, or by using them one after the other. Do this by wrapping an ice-pack in a towel or by soaking a towel in hot water and applying it to the anal region. You can do this several times each day but for no longer than 15-20 minutes at a time. Reducing swelling can help make thrombosed haemorrhoids less likely to burst and aid in the healing process.

As in all cases with haemorrhoids, don’t spend excessive time straining on the toilet as this will only put fresh pressure on the veins and potentially cause another rupture or yet more bleeding. Treat your haemorrhoid-affected area as you would any part of your body that’s recently been damaged.

It’s also a good idea to avoid spending too much time sitting, so as to avoid putting added pressure on your haemorrhoids. Stay active as much as possible. If you work at a desk, get up and take a quick walk every so often to give your anal area a chance to rest. This also helps reduce your chances of becoming constipated.

Constipation is, after all, one of the key reasons for haemorrhoids to develop (and stick around) in your rectum or anus. Consume plenty of fibre-rich foods and drink plenty of water to keep your stool soft and easily-passable. The softer your stool is, the less chance there’ll be of your haemorrhoids becoming damaged and bleeding again. Hard stool can be a real setback in your recovery.

 

When to see the doctor

If you’re still finding blood during or after a bowel movement and home treatments aren’t working, you should go see your doctor as soon as possible. Blood in the stool can be a symptom of more serious conditions, especially if it continues unabated.

In order to determine the source of the bleeding, your doctor will inspect the area and may examine the rectum for internal haemorrhoids.  He or she may also suggest trying a colonoscopy if the source of the bleeding isn’t obvious. Always inform your doctor if, in addition to bleeding, you notice that your stool changes colour, your experience weight loss or anal pain, you feel dizzy or lightheaded, you are nauseous, your bowel movements change drastically, or you have abdominal pain.

 

What the doctor may recommend

Your doctor may suggest a number of other procedures to help treat your haemorrhoids if they’ve been bleeding. These include sclerotherapy, rubber band ligation, electrocoagulation, or bipolar, laser or infrared coagulation, or the latest treatment known as The Rafaelo Procedure, which is offered as a day case, usually under local anaesthetic, after which you should be able to return to work within a day.

In more extreme cases, your doctor may suggest that you undergo a more advanced treatment for your haemorrhoids, such as surgery, especially if they bleed excessively or you develop a prolapsed haemorrhoid (when the haemorrhoid hangs down out of your anus). The type of surgical procedures your doctor could recommend include a haemorrhoidectomy (surgical removal of a prolapsed internal haemorrhoid or a complex external haemorrhoid), a DG-HAL (Doppler guided haemorrhoid artery ligation), or a haemorrhoidopexy, during which a surgeon uses surgical staples to reattach a prolapsed haemorrhoid back to the inside of the rectum.

These more invasive procedures are generally undertaken under general anaesthesia and often involve significant downtime, usually around 3 weeks, for the pain to subside before you can return to work.