Haemorrhoids

What are haemorrhoids?

Haemorrhoids are dilated veins in the anal canal that bleed and can be painful.

This is a common condition that is aggravated in patients who do not have enough fibre in the diet and as a result are constipated.

Many cases are successfully treated with local ointments and diet changes as well as stool softeners.

More severe cases often need surgery as the bleeding can cause significant blood loss , and the pain can be disabling.

This was thought to be a venous condition like varicose veins but is now known to involve a change in the circulation of the anal region where the arterial supply is increased and causes veins to become large and bleed.

Surgical Treatment:

Surgical treatment is possible with procedures which use cutting out of the haemorrhoids (Haemorrhoidectomy), or use staples to cut off circulation to the haemorrhoids (Circular Stapling). An alternative procedure called Doppler Guided Haemorrhoidal Artery Ligation (DG-HAL) uses a special ultrasound probe to find the arteries supplying the heamorrhoids and then ties them off using a thread.

All these procedures involve admission and significant pain, as well as can cause loss of control of stool passage to a greater or lesser degree in a few patients. Haemorrhoidectomy and stapling are the most successful treatments but also have the higher pain after surgery and also complication rates. The complication rates in trials have been upto 20% .

Endovascular Treatment:

The blockage of arteries supplying the heamorrhoids is easily done by endovascular techniques and this a PAIN FREE procedure requiring just local anaesthesia and can be done as a DAY CARE procedure without any hospital stay.

The procedure involves entering the arterial system either at the wrist or the groin and blocking the arteries supplying the haemorrhoids with coils . This leads to symptom improvement and stops bleeding within days. 80 -90% of patients reported great satisfaction with this treatment after 6 months of procedure. This is a simple and pain free method not involving general anaesthesia or hospital admission.