Treatment of Haemorrhoids

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For most people with haemorrhoids, the condition is mild and can be treated with over the counter (OTC) medicines that tackle the symptoms. The haemorrhoids will eventually go away without treatment. Haemorrhoids caused by pregnancy will usually go away after the baby has been born.

Symptoms can be treated with agents that soothe the pain, usually in the form of ointments or suppositories. Corticosteroids are often combined with local anaesthetic agents and are helpful for short-term use (up to 7 days). They are not recommended for long-term use or for use in children.

Where haemorrhoids are more serious, surgery or other treatments may be necessary. Surgical removal of piles is called haemorrhoidectomy. Most piles are not treated by haemorrhoidectomy, because an effective alternative procedure is rubber-band ligation. In this method, a tight rubber band is placed round the neck of the pile so that its blood supply is cut off and it shrivels. Other methods include injection with a solution that causes the blood to clot, destruction by freezing and treatment with a laser.

Haemorrhoidectomy is reserved for those cases in which the piles are large and internally placed. The operation involves tying a tight string (ligature) around the base of the pile to control bleeding and cutting off the outer part. This leaves raw areas of bowel lining which, over the course of three or four weeks, become covered with the normal inner-surface membrane (epithelium). During this period, the stools are kept soft by the use of water-retaining agents such as methyl cellulose.

The results are generally good and only a small proportion of people operated on have recurrent symptoms. During the immediate post-operative period, however, men may find difficulty in passing urine for a time and there may be a slight tendency to incontinence.