London Colorectal – FAQ

Haemorrhoids and Piles

What are haemorrhoids or piles?
Haemorrhoids are vascular tissue that forms two sets of piles in the normal rectal anatomy. These
piles are located in the upper part of the anus (internal haemorrhoids), and underneath the skin at
the edge of the anus (external haemorrhoids).

Why do we have haemorrhoids?
The internal haemorrhoids help the bowel control providing a fine closure of the back passage
from inside as a kind of mechanical plug.
The external haemorrhoids are not normally visible and do not really contribute to the function
of the anal canal.

What are the symptoms of haemorrhoids?
The most frequent symptom of haemorrhoidal disease is bleeding, normally reported as bright
red. Other symptoms include protrusion of the haemorrhoids and feeling of a lump known as
haemorrhoidal prolapse, mucous discharge, itching and at times pain.

How are haemorrhoids graded?
Grade 1 haemorrhoids – the haemorrhoids bleed but do not prolapse;
Grade 2 haemorrhoids – the haemorrhoids prolapse through the anus on straining but reduce
Grade 3 haemorrhoids – the haemorrhoids prolapse through the anus on straining or exertion and
require manual replacement into the anal canal;
Grade 4 – the anal cushions are constantly prolapsed.

This classification is therefore a clinical classification based on the actual symptoms rather than
size or appearance of haemorrhoids.

Management of haemorrhoids
Most of patients with early stages haemorrhoids and minimal prolapse will respond to non-operative methods. When these have failed other forms of treatment that can give more immediate symptomatic relief include rubber-band ligation, injection sclerotherapy, infrared coagulation.
For more advanced stages conventional surgical treatment consist of formal removal of haemorrhoids. This procedure can be very painful and recovery time can take a few weeks. THD TM procedure is an alternative minimally invasive operation suitable for all patients requiring surgical intervention for haemorrhoids, regardless of the degree. The piles are not removed but simply corrected using a few absorbable sutures.
>> Watch the video of a THD procedure with Targeted Mucopexy for advanced haemorrhoidal disease <<