Dr Chris Steele discusses a new procedure called HALO for the treatment of haemorrhoids (piles).

HALO is new less painful operation to treat haemorrhoids (piles).

A new procedure to treat haemorrhoidsis available, called haemorrhoid artery ligation operation (HALO). Before explaining the procedure and its benefits, here is some background material on haemorrhoids.

What are haemorrhoids?
Haemorrhoids (also know as piles) are swollen blood vessels in and around the anus (back passage). These swollen vessels can cause pain, irritation and discomfort. They can also bleed and discharge mucus.

What causes haemorrhoids (piles)?
The cause of haemorrhoids is increased blood pressure in the blood vessels of the rectum and anus. This can can result from straining when on the toilet. Other factors include: lack of fibre in your diet; being overweight; being constipated on a regular basis; regularly lifting heavy objects ; being are over the age of 50; pregnancy; having prolonged diarrhoea.

Are haemorrhoids common?
Yes, over 50% of the population will suffer from haemorrhoids at one time or another.

What are the symptoms of haemorrhoids?
There are various symptoms, and often people are not aware that they have haemorrhoids, and they can go away on their own in a few days. Symptoms include:
  • itchiness around your anus
  • discomfort around your anus, such as feeling sore or it being visibly red
  • excessive straining when passing a stool
  • bleeding after you have passed a stool
  • discharge of mucus present after passing a stool
  • pain while passing a stool
  • feeling like your bowels are still full and need emptying


Treatments for haemorrhoids
Treatment varies depending on the cause and nature of the the haemorrhoids. Softening of your stool to help its passage will often relieve sysmptoms. This can be done by increasing the fibre in your diet, e.g. by eating wholefoods, fruit and vegetables. Also drink lots of water.

Various creams and ointments are available on the market for haemorrhoids. However these will only relieve the symptoms, not cure them.

Surgical procedures
There are a number of surgical procedures to remove or reduce haemorrhoids. Banding involves putting a small rubber band around the haemorrhoid which can make it shrink. This can be done by your GP. Sclerotherapy involves a chemical solution being injected around the blood vessels which shrinks them, causing them to eventually fall off. In extreme cases invasive surgery will be used to cut them away (haemorrhoidectomy).

The new prodedure Haemorrhoid Artery Ligation Operation (HALO)
This technique has been around for 4 years and involves an ultrasound probe to locate the blood flow to the piles, they then tie these blood vessels off and leave them to shrivel up. The benefits of this are a much simpler procedure, and much faster recover time compared to other procedures. As no incisions are made it is relatively painless and can be carried out as a day surgery procedure. Finally this procedure can be carried out without the need for general anaesthetic.

Description of HALO
First, an ultrasound probe is inserted which identifies the blood supply feeding the piles. The probe has a little window on the side and once the blood vessel that is feeding the pile is located, a needle is fed with a stitch attached through the centre of the probe and through the window to tie off the blood vessel. There are very few nerves in this region so this isn't painful after the anaesthetic has worn off.

The whole procedure takes about 20 minutes. Finally all patients have some local anaesthetic injected into the area to minimise any pain. Those who have elected to have it done under sedation will have had the local anaesthetic beforehand. Patients can go home a few hours later. They might have a little bleeding, but this is nothing to be concerned about.

Dr Chris Says
If you have any discomfort in your back passage or when going to the toilet, or if there is blood or muscus in your underwear or in the toilet after going, you should see your GP immediately.


This content was created on Wed 28 May 2008

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