The different treatment options for haemorrhoids

Haemorrhoids, also known as piles, are swollen veins inside or around the bottom (rectum and anus). They’re very common and can affect people of all ages. While they can be uncomfortable, effective treatments are available, ranging from simple lifestyle changes to minimally invasive procedures and surgery.

What are haemorrhoids and what symptoms do they cause?

Haemorrhoids develop when blood vessels in the rectal area become enlarged and swollen. This can happen due to straining when going to the toilet, constipation, pregnancy, or simply as a result of ageing tissue.

Common symptoms include:

Bleeding when passing stools (usually bright red)
Itching or irritation around the anus
Lumps or swelling felt around the bottom
Discomfort or pain, especially if haemorrhoids prolapse (protrude outside)

Although bleeding is often caused by haemorrhoids, it is important to see a doctor to rule out other causes such as bowel polyps or cancer.

When should you see a doctor?

Anyone with rectal bleeding, ongoing discomfort, or lumps around the anus should seek medical advice. A doctor can confirm whether haemorrhoids are the cause and discuss the most appropriate treatment.

What are the treatment options?

Treatment is tailored to the severity of symptoms. In many cases, haemorrhoids can be managed without surgery.

Lifestyle changes and self-care

Eating more fibre (wholegrains, fruit and vegetables) to keep stools soft
Drinking plenty of fluids
Avoiding straining on the toilet
Using moist wipes rather than dry tissue to reduce irritation
Taking warm baths to soothe discomfort

Medications

Creams, ointments or suppositories to reduce swelling and itching
Short courses of topical steroids if inflammation is significant
Pain relief such as paracetamol if required

Minimally invasive procedures

Rubber band ligation: a small band is placed around the haemorrhoid to cut off blood supply, causing it to shrink and fall off.
HALO (Haemorrhoidal Artery Ligation Operation): uses ultrasound to locate and tie off blood vessels feeding the haemorrhoid, reducing swelling with minimal pain.
Rafaelo procedure: a modern technique using radiofrequency energy to shrink haemorrhoids under local anaesthetic, with a quick recovery.

Surgery

For severe or persistent haemorrhoids, a haemorrhoidectomy (surgical removal) may be necessary. This is usually reserved for cases where other treatments have not worked, or when haemorrhoids are very large.

What is the outlook for patients?

Most people experience significant improvement with appropriate treatment, often without needing surgery. Modern procedures such as HALO and Rafaelo are less painful than traditional operations and allow patients to return to normal activities quickly.

If you have symptoms suggestive of haemorrhoids, don’t be embarrassed to speak to your doctor. Early assessment ensures the right diagnosis and the most suitable treatment to relieve discomfort and improve quality of life.