If conservative treatments and/or medication have not worked and your haemorrhoids are large and causing you discomfort and pain, you may wish to consider surgery. There are some different surgical options available and you should discuss these with your GP who can refer you to a consultant.
A haemorrhoidectomy is an operation to remove the haemorrhoids and is usually done under a general anaesthetic. This is a major operation and you will need to take at least a week off work afterwards. It is unlikely that your haemorrhoids will come back after having this procedure, however, you should still continue with a high fibre, healthy diet to reduce any risk.
Other surgical procedures you may wish to consider:
Stapling, also known as stapled haemorrhoidopexy, is an alternative to a traditional haemorrhoidectomy and is a procedure only used for external haemorrhoids. It requires a general anaesthetic and a hospital stay.
Haemorrhoidal artery ligation, also known as transanal haemorrhoidal dearterialisation (THD), is an operation to reduce the flow of blood to the haemorrhoids. It is usually carried out under general anaesthetic and uses ultrasound to locate the haemorrhoids. A stitch is then placed in the artery supplying blood to the haemorrhoid, which results in it shrinking and dying off.
THD or Transanal Haemorrhoidal Dearterialisation uses ultrasound Doppler to target and stitch the haemorrhoidal arteries to reduce the blood flow to the haemorrhoids and achieve shrinkage. This minimises bleeding, prolapse and discomfort. There is no cutting involved in this procedure which greatly reduces the risk of associated pain and full recovery can be achieved much quicker.
This procedure may also be referred to as Haemorrhoid Ligation or Artery Ligation or Doppler Guided Ligation.
NICE (National Institute for Health and Clinical Excellence) issued their guidance in 2010 and current evidence on haemorrhoidal artery ligation states that the procedure is an efficacious alternative to conventional haemorrhoidectomy and there are no major concerns.
The procedure is carried out in private hospitals and centres around the country but NHS treatment is available via the Choose & Book system.