Email: enquiries@pelvichealthandwellbeing.co.uk
Haemorroidal Treatment
Although haemorrhoids are responsible for considerable economic costs and personal suffering, these are one of the most common anorectal diagnosis in our patients in the Emergency Department. This does affect the patient’s quality of life significantly.
We have a range of treatment options that are available which can be carried out under general anaesthetic or local anaesthetic with or without sedation so it causes minimal discomfort and interference to patient’s daily life to give them the best outcomes.
These treatment options include:
- Banding – bands are applied to shrink the haemorrhoids. These are normally the first line treatment for grade 2 haemorrhoids or grade 3 haemorrhoids without any mucosal prolapse. These give reasonable results. With banding changing diet and lifestyle make a huge difference with patient’s benefitting from this.
- Sclerotherapy -This again is a successful treatment which has been around for quite a long time. It has fallen out of favour due to the establishment of new treatments forms including trans haemorrhoidal de-arterialisation but again it is an under utilised treatment option which works very well for a group of patients which I do carry out.
- Trans haemorrhoidal de-arterialisation with or without mucopexy – this treatment option has been around for quite a while. Outcomes are very good, especially with bleeding. Trans haemorrhoidal de-arterialisation is very good for grade 2/3 patients especially in grade 2 patients who fail banding or have attempted banding once or twice prior to proceeding to trans haemorrhoidal de-arterialisation. Patients who have mucosal prolapse and mucopexy will help reduce the haemorrhoids. I do offer a combination of trans haemorrhoidal de-arterialisation and mucopexy and also excision of the external component to reduce the discomfort that patients suffer with open haemorrhoidectomy.
- Rafaelo – Radio frequency ablation of haemorrhoids which can be caried out under local anaesthetic. Currently we have been successful in treating patients with grade 2/3 haemorrhoids for bleeding. This promising procedure can be carried out under local anaesthetic. We are still evaluating the procedure with regards to larger haemorrhoids. It does not treat external haemorrhoids but internal haemorrhoids and haemorrhoids with mucosal prolapse seems to be very promising with this particular procedure. The main advantage of this procedure is this can be carried out easily in an outpatient setting.
- Open haemorrhoidectomy- open haemorrhoidectomy is generally reserved for grade 4 haemorrhoids and large haemorrhoids with mucosal prolapse which have failed other treatments. It is probably the most uncomfortable procedure, but it does improve the patient’s quality of life significantly. I will be able to assess you with regards to the different types of haemorrhoidal treatments that are available and identify the optimum choice for you. Following surgery, I will keep a very close eye on you to make sure that you are comfortable at all times by prescribing analgesia.
OUR OTHER SERVICES
Rectal Prolapse
This can be a debilitating condition. I currently undertake Laparoscopic ventral mesh rectopexy (Lap VMR),
Delormes procedure, Altemeier’s procedure Unfortunately can affect elderly patients who can be frail.
Faecal
Incontinence
Faecal Incontinence affects a significant number of patients with almost 20% of patients thought to be affected. Until recently treatment options were limited. Most patients present following obstetric injury.
Constipation
One of the commonest diagnoses with up to 20% of the population suffering. Primary or secondary to other medical conditions which can include neurological and metabolic conditions.
Obstructive Defecation
Obstructive defection affects a group of patients who normally present with symptoms similar to constipation. We do assess this as a separate group of as the issues tend to be related with opening their bowels.
Haemorrhoidal Treatment
Although haemorrhoids are responsible for considerable economic cost and personal suffering. These account for one of the commonest anorectal diagnoses in outpatients and emergency depts.
Anal Fissures
One of the common conditions that we see but the one that affects patients quite significantly where they are unable to open their bowels and when they do, the muscle spasm causes them significant pain and discomfort.
Anal Fistulas
Anal fistulas can be quite a difficult problem to treat and this generally follows patients who have perianal abscesses which are either drained or sometimes discharge spontaneously or are treated successfully with antibiotics.
Pilonidal Sinus Disease
Pilonidal sinus disease (PD) is most commonly seen in and around the natal cleft. The reported incidence is around 25 per 100,000 with a male to female ratio between 3:1 and 4:1.
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