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What are haemorrhoids?

These are swellings inside the anus containing enlarged blood vessels. In some cases, haemorrhoids are little more than a nuisance and you may not be too bothered by them. 

What are the causes?

Haemorrhoids are more common in people who spend time straining at stool, so avoidance of constipation is paramount in order to prevent them getting bigger. Haemorrhoids are common during pregnancy, and often improve after giving birth. 

What problems can they cause?

In some cases, haemorrhoids are little more than a nuisance and you may not be too bothered by them. They can cause itching, intermittent bleeding, and can sometimes prolapse when you empty your bowel. 

Thrombosis of a haemorrhoid occurs when blood clots in the haemorrhoid, causes a large swelling, and is very painful. With painkillers and time, this settles back to normal. This normally takes 1-2 weeks. An operation on a thrombosed haemorrhoid can cause irreparable damage, and should be avoided. 

Can they be treated without surgery?

Once haemorrhoids cause symptoms there are a variety of treatments.

  • Medicine: Ointments and suppositories can be applied to calm down angry inflamed haemorrhoids. Most people will need nothing more than this.
  • Banding/injection: A handheld device is used to apply elastic bands to the base of the haemorrhoid, causing it to shrivel up. This is only suitable for small haemorrhoids.

What operations are available?

Surgery should only be carried out when recommended by a surgeon, and after a discussion of the benefits and risks. 

  • Haemorrhoidopexy: This is performed as day surgery, requiring a general anaesthetic. Sutures are placed around the haemorrhoid and inside the anal canal, to correct the prolapsing tissue. Recovery is usually fairly comfortable, but haemorrhoids can return over time.
  • Haemorrhoidectomy: This is the surgical removal of the haemorrhoidal tissue, under general anaesthetic, and going home the same day. The haemorrhoids are removed, and the area is allowed to heal over gradually. This takes around 2 weeks, and is very uncomfortable whilst this happens. We would advise taking this time off work to let things settle down. You would normally leave hospital with a short course of antibiotics, strong painkillers, and laxatives. There is a risk of bleeding, scarring, and a small risk of damage to the muscles around the bottom. 

What are the risks of surgery?

Common risks of haemorrhoid surgery include bleeding, pain, and infection. Surgery will leave an internal scar, and the surgeon will be careful to place incisions so that this does not cause narrowing of your anus. Care is taken to avoid any damage to the muscles of the anus, which would affect your continence. The risk of a general anaesthetic will vary from person to person, depending on their general health. 

What if I do nothing?

Once a diagnosis of haemorrhoids has been made, it is perfectly safe to leave them alone. Your doctor may want to do further tests to make sure there are no other bleeding points higher in the bowel. 
Haemorrhoids often cause little more than discomfort, and treatment should be tailored to your symptoms. 

Further sources of information

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If you have any queries relating to this information, please contact the General surgery service.

About this information

Service:
General surgery

Reference:
Y/059

Approval date:
6 May 2025

Review date:
6 May 2028

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Important note 

This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.