The most common haemorrhoid / piles symptoms for men and women is either rectal bleeding on the paper or in the pan that can be accompanied with swelling or discomfort in the anal area. Occasionally persistent perianal itching especially at night can also be a symptom. They are caused by the natural vascular veins in the area swelling and leaking due to excessive straining when on the toilet due to constipation or can be something that people are simply prone to developing.
In some people these symptoms will be periodic and simple lifestyle measures (such as eating healthier) or over the counter creams (Anusol) will give some relief.
It is often difficult to know what causes certain swellings, discomfort or bleeding and thus we suggest seeing one of our colorectal surgeons to get a definitive diagnosis and treatment plan. Patients often don’t know whether the symptoms they experience are from anal skin tags that can occur from previous or coexisting haemorrhoids or haemorrhoids themselves. The only way to tell for certain is to have a proctoscopy (internal examination of the anal canal / rectum) which is routinely done at our clinics. If you speak to one of our advisors they will be able to help you determine who is the best doctor to see.
It is often difficult to tell the difference between haemorrhoids and anal skin tags. Haemorrhoids are often the cause of anal skin tags and can still coexist with anal skin tags. As a guide, if you answer yes to any one of these 3 questions, then you maybe suffering with haemorrhoids:
- Have you had rectal bleeding on the paper or in the pan more than twice in the last 6 months?
- Have you had pain or discomfort going to the toilet on regular basis in the last 3 months?
- Do you have large degree of swelling that lasts for 2-3 days after passing stools in the last 3 months?
If you answer ‘Yes’ to any of these questions, that is a good indication that you may have haemorrhoids. It is always best to treat the haemorrhoids to help prevent recurrence. If you have both haemorrhoids and skin tags, then skin tags can be treated at later date if needed.
If you answer ‘No ‘ to ALL the above and have persistent lump/tags in the area, then anal skin tags maybe the cause of your symptoms; especially if you have concerns about cosmetic appearance/embarrassment/wiping hygiene/minor irritation.
Haemorrhoids Treatment Options
You will be assessed by our consultant colorectal surgeons Mr Alex Von Roon and Mr Gurjar at our Harley street clinic or Mr Piero Nastro at our London City clinic using a proctoscope to examine internally for any piles or haemorrhoids.
Depending on the findings, various treatment options are available at the same appointment should you want to proceed:
- Banding haemorrhoid treatments involve putting a tiny rubber ligature around the haemorrhoid which cuts of the blood supply so that the pile simply shrivels and falls away.
- Injection haemorrhoid treatment involves injecting a glue like substance that causes the haemorrhoids to shrink and collapse.
- Rafaelo Procedure – this uses radiofrequency to treat the piles by heating them up and causing them to shrink and seal off. The success rate is around 90% which means it’s a single one-off treatment in most cases.
There is a possible 25-35% recurrence rate, so it may need repeating at some point in the future; but is a good affordable option for those with simple haemorrhoids.
Walk in walk out in 30-45 mins
Return to work within 24-48 hours
90% success rate
Rafaelo Results Duration
ONE OFF treatment in most cases
Haemorrhoid Treatment Costs
|Consultation with Colorectal Consultant||£295|
|Consultation follow up (proctoscopy included in follow ups)||£250|
|Anal skin tag from||POA|
|Anal fissure small||£550|
|Anal fissure large||£750|
Consultations are with Mr Alex von Roon, a leading London teaching hospital consultant colorectal surgeon.
During the consultation you will have a detailed consultation about your concerns. The examination normally requires a proctoscopy examination which is a gentle quick procedure to identify if there are any haemorrhoids or any other issues. A treatment plan can then be discussed and you can then return at a later date to have them treated at a convenient time. Consultations are valid for 3 months, after which another consultation may be required to check for any change in symptoms prior to treatment.
Comparison of Rafaelo vs Other Haemorrhoid Treatments
Rafaelo has the following benefits over other haemorrhoid treatments:
|Rafaelo||Injection||Banding||Exroid||HALO Surgery||Excision Surgery|
|Local or Sedation / General Anaesthetic||Local||None||None||None||General Anaesthetic / Sedation||General Anaesthetic|
|Single or multiple treatments||Single||Single/Multiple||Single/Multiple||Multiple||Single||Single|
|External shrinkage of protrusion||Yes||No||Minimal||No||Yes||Always|
Haemorrhoid Treatment At Cosmedics, London
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Haemorrhoid Treatment FAQ: Questions & Answers
Can I see a video of how Rafaelo haemorrhoid treatment works?
What are haemorrhoids?
Haemorrhoids (also known as ‘piles’) are swollen cushions of blood vessels around or just inside the anal canal (back passage). There are two kinds of a haemorrhoid: internal and external.
These haemorrhoidal cushions are normal anatomical structures but are made to swell and balloon by straining on the toilet, pregnancy, heavy lifting, family history, overweight that then cause bleeding, itching and soreness, discomfort, mucous discharge and protrusion through the anus.
What are the risks of the rafaelo procedure?
All treatments and procedures have risks. The most common risks post-procedure and during the following 2 weeks include discomfort, mild bleeding or spotting or anal discharge and faecal urgency in the first 48 hours. Other rarer post-procedure complications might include recurrence of symptoms, infection, ulceration, fissure, or significant bleeding/haemorrhage.
Your consultant will discuss the benefits and risks of The Rafaelo Procedure during your initial consultation.
What happens at the haemorrhoids appointment?
- You will be greeted by our friendly staff and have a chaperone allocated to you.
- You will then have a full clinical assessment with Mr von Roon who is a leading London teaching hospital colorectal surgeon.
- He will perform clinical examination including a proctoscopy, where a small plastic telescope is inserted into the back passage to confirm a diagnosis.
- Once a diagnosis is made he advise you whether your haemorrhoids are suitable for treatment and discuss the treatment options with you. You can then decide when to schedule treatment
- A band is placed tightly around the haemorrhoid.
- This only takes a few minutes and doesn’t generally require local anaesthetic.
The Rafaelo procedure:
- Takes about 10-20 minutes and is performed under local anaesthetic
- You will be reviewed at 4 weeks once it has taken time to fully resolve.
What happens if I have anal skin tags as well as haemorrhoids?
By undergoing the Rafaelo treatment, this will not only help prevent this from happening again but may also improve the anal skin tags by causing the tissue internally to contract and pull up some of the excess skin.
If after 2 months there is still residual skin then you can opt to have this removed under local anaesthetic by our cosmetic doctors and plastic surgeons.
What if I get pain following haemorrhoid treatment?
Take 2 tablets (1000 mg) of paracetamol every 4 to 6 hours. If this is not sufficient, add in 2 tablets (400 mg) of ibuprofen every 4 to 6 hours. You can take both painkillers together safely. Some people have contraindications to ibuprofen – check with Mr von Roon on the day or with your doctor or pharmacist. If the pain is uncontrolled with above please contact Mr von Roon.
What haemorrhoid treatments are available?
Lifestyle changes to diet, to increase oral fluid and fibre intake thereby softening the stool will help reduce straining avoiding straining and avoiding strenuous lifting.
Treatment options are radiofrequency (Rafaelo), ligation (rubber banding) and injections. These are carried out as outpatient day cases under local anaesthetic. For more extensive haemorrhoids surgical removal under general anaesthetic is required.
Where does the treatment and consultation take place?
The consultation and treatment take place at 41 Harley Street, London W1G 8QH. The clinic is registered with the CQC (Care Quality Commission) with an inspection report in August 2019 passing it as good.
Will I be able to open my bowels after haemorrhoid treatment?
You will be able to open your bowels normally. This should not be more painful than normal. As mentioned above, you may experience the urgency of defaecation.
Will I be able to work the next day?
Most people are able to work the following day. However, if you get urgency this can be a little unpredictable, so if you have the option of working from home, it is advisable to do this on the first day.
Is the rafaelo procedure safe and effective?
As the Rafaelo procedure is a novel treatment and the evidence base for it is still being established, the National Institute for Health and Clinical Excellence (NICE) has recommended that it should be used with special arrangements for clinical governance, consent and audit.
At Cosmedics, we keep careful records of all Rafaelo cases performed and regularly audit our clinical outcomes for the procedure.
If rafaelo is not suitable do you offer haemorrhoid banding or injection?
Yes, both rubber ligation (banding) or injection of sclerosant (Phenol) is an option should Rafaelo radio-frequency not be appropriate or surgery in severe cases.
On assessment, your colorectal consultant will discuss the best options for your haemorrhoid treatment.
How do I know if I have just anal skin tags or a protruding haemorrhoid ?
Anal skin tags are caused by the swelling of the pile or haemorrhoid externally causing the skin to stretch. Once the haemorrhoid shrinks people can often be left with anal skin tags. These anal skin tags can be treated by us separately, but you need a surgeon assessment to ideally diagnose what is the true cause of anal skin swelling.
Key symptoms on opening bowels
- Swelling of skin tag = skin tag and haemorrhoid
- Bleeding and sharp pain that lasts for few hours = fissure (tear in anal skin)
- Bleeding and minimal if any discomfort = haemorrhoid
Haemorrhoid vs Skin Tag Checker for Protruding Anal skin
|Haemorrhoid||Skin Tag||Haemorrhoid + Skin tag||Fissure (tear in the skin)
|Bleeding on opening bowels||Yes on paper, stool and in toilet||Not common||Yes on paper mainly or stool||Yes
|Pain on opening bowels||Not common||Not common||Discomfort only not pain||Yes sharp lasts for few hours
|Swelling of skin or lump on opening bowels||Yes||Not common||Yes||No|
Does the rafaelo haemorrhoid procedure work for everyone?
We find that in practice, 9 out of 10 people are very satisfied with the outcome of the procedure for treating haemorrhoids.
One in 10 feel that their haemorrhoid symptoms are not improved sufficiently afterwards. In these cases, the Rafaelo procedure can be repeated, or an alternative treatment like excision of remaining anal skin tags or traditional haemorrhoidectomy may be required.
Mr von Roon will advise you on this when you attend for the follow-up consultation after your haemorrhoid treatment.
Do I need to change my diet or have an enema for the procedure?
You can eat as normal before and after. There is NO need for an enema (clearing out of bowels with laxative).
We advise that you increase the amount of fibre in your diet and your fluid intake in the first two weeks after the procedure to avoid constipation.
Can I exercise after haemorrhoid treatment?
For exercise such as running, swimming and cycling and strenuous activities resume as normal after 2 weeks.
Can I have the rafaelo haemorrhoid procedure if I am homosexual?
Yes, it is a common occurrence to have haemorrhoids in homosexual men.
It can be very embarrassing and awkward to have haemorrhoid symptoms. There is also the sexual health risk to consider due to the increased likelihood of bleeding during intercourse with haemorrhoids.
Haemorrhoid treatment is ideal for patients who just want to get back to normal daily lives as quickly as possible and not have to worry about it again.
AFTERCARE INFORMATION – Haemorrhoids
For detailed information:
Rafaelo Treatment for Haemorrhoids
The Rafaelo Procedure is the latest advanced treatment for haemorrhoids.
This procedure uses radiofrequency technology to reduce, and in most cases, eliminate, the common symptoms of internal (Grade 1-3) haemorrhoids by heating them up and causing them to shrink and seal off.
This pioneering technology has revolutionised how we are able to treat piles. Rafaelo is a minimally-invasive walk in walk out treatment which typically takes no longer than 15-20 minutes to perform.
The success rate is around 90% which means it’s a single one-off treatment in most cases.
Key Features of Rafaelo Haemorrhoid Treatment
- Can help shrink and reduce the external protrusion of certain haemorrhoids making the symptoms in that area much more comfortable
- 90% success rate – higher vs other walk in walk out procedures
- One-off single treatment
- Minimal/low discomfort during treatment – only requires a local anaesthetic
- Quick and less painful recovery than comparable surgical procedures
- Short post-operative recovery time