Haemorrhoids, often called piles, are areas in the anal canal where tissue containing blood vessels has become stretched or swollen and may extend beyond the anal canal opening either intermittently or permanently.
 
The main types of haemorrhoids are:
 
Internal haemorrhoids – arising from the lining of the lower rectum and anus

External haemorrhoids – arising from the skin around the opening of the anus
 
It is not unusual to have both internal and external haemorrhoids at the same time.

Surgical Excision – Haemorrhoidectomy or surgical excision is usually undertaken for the treatment of combined internal and external haemorrhoids and less commonly for permanently prolapsed non-reducible large haemorrhoids.  Haemorrhoidectomy is undertaken in a hospital operating theatre under general anaesthetic. Haemorrhoidectomy is very effective in achieving relief of symptoms and it is relatively uncommon for symptomatic recurrence to occur, although occasionally minor anal skin tags can persist after surgery and will be removed under local anaesthetic as an office procedure.  The procedure can be quite painful and for this reason post-operative analgesia, dietary advice and stool softening medication is arranged for the post-operative period. Complications such as post- operative infection and significant post-operative bleeding are uncommon and any evidence of these should be reported to your surgeon as soon as possible. Information covering your post-operative management and expectations will be provided pre-operatively. Return to normal activities occurs usually within 2-4 weeks.

You will routinely be contacted by the clinic nurse during the early post-operative period and be seen by the surgeon for review 2-3 weeks post operatively or beforehand if there any concerns.  Small thrombosed haemorrhoids can be excised surgically using local anaesthetic as a Room’s procedure.