(Piles) are vascular structures in the anal canal which help with anal continence. They become pathological if they become swollen, inflamed or bleed. They are classified as internal or external and can occur in combination. The most common presentation of internal haemorrhoids is painless rectal bleeding. External haemorrhoids usually present with anal pain. The mainstay of treatment is conservative management. This includes anti inflammatory and pain medication, high fibre intake, saline sitz baths and rest. Haemorrhoidectomy is the surgical excision of the haemorrhoid. It is associated with significant post operative pain and usually requires 2–4 weeks for recovery.
Doppler Guided Haemorrhoidal Dearterialisation (THD Procedure)
Doppler guided transanal hemorrhoidal dearterialisation is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood supply to the haemorroid. These arteries are then occluded and the prolapsed tissue is sutured back to its normal position. It has a similar recurrence rate to haemorrhoidectomy. This procedure has the advantage of significantly less pain and can be repeated.