Alternatives tohaemorrhoid surgery

Over 80% of people treat their haemorrhoids successfully without surgery.

Prevention and at-home treatments

One of the best ways to reduce the discomfort of haemorrhoids and help prevent them from recurring is to avoid and treat constipation, a major risk factor for haemorrhoids. There are several things you can do to help keep your bowel motions soft and regular:

Increase your fibre intake

The best way to increase your fibre intake is to incorporate more fibre-rich foods into your diet. Choose wholegrain breads and cereals, fruits, wheat bran, prune juice, vegetables (especially beans, peas and other legumes), nuts and seeds. Try and avoid processed foods, including canned fruits, white bread and pasta.

If you have trouble adding enough fibre to your diet, there are also fibre supplements available from your pharmacy that are specifically designed to reduce constipation. They contain fibre from inulin, wheat dextrose, psyllium or methylcellulose. All are effective in preventing constipation and softening stools. When you’re taking a fibre supplement, it’s important to drink extra water to make it work properly.

As well as helping to prevent constipation, fibre has other benefits for your health. It can help lower your cholesterol, control blood sugar levels, improve colon health and can also help you achieve a healthy weight.

Fibre supplementation really has no downsides, apart from possibly causing flatulence, bloating and/or cramps if you increase your intake too suddenly.

Take laxatives or stool softeners

If other measures haven’t worked, you can take a laxative or stool softening medication. If you need to use laxatives regularly or in large amounts, you may have side effects which include low potassium levels.

Do regular exercise

A half hour walk every day will help make it easier to move your bowels regularly.

Drink plenty of water

Water helps to keep stools soft, so make sure you stay well hydrated throughout the day.

Don’t hold it in

Don’t wait. Visit the toilet as soon as you feel the urge to move your bowels.

Avoid straining

If you’re prone to haemorrhoids, it’s important to try and avoid straining on the toilet. Straining is usually caused by constipation. Straining is also a risk factor for stroke and heart attack.

Limit your time on the toilet

If nothing happens, don’t wait or try to force it. Come back later.

Change your seating position on the toilet

Squatting is the optimal position to evacuate the bowel but the way our toilets are designed doesn’t make this practical. You can improvise a semi-squatting position by putting a box or some phone books under your feet. This can make it easier to empty your bowels without straining.

Wipe gently

Dampening toilet paper before you use it can make it less irritating.

Take warm baths

To relieve discomfort, fill your bath with a few inches of warm water and soak for around 15 minutes.

Ice packs

Make a small ice pack and put it on the painful spot several times a day.

Wear loose cotton underwear

Avoid tight clothes. They can encourage moisture to build up which can make the symptoms worse.

Avoid sitting for long periods

Sitting can cause or aggravate haemorrhoids, so make sure you take frequent breaks.

Sit on a pillow

Sitting on a soft surface can ease the discomfort of haemorrhoids and help to prevent them. Avoid rubber ring cushions which can make the haemorrhoid worse.

Push it back in

If you have a haemorrhoid that’s protruding from your anus, you can try to gently push it back in. Use a gloved finger coated in a non-toxic water-based lubricant.

Relieving the discomfort

Ointments, creams and suppositories

A dab of petroleum jelly (Vaseline®) on the area can make bowel movements more comfortable. Witch hazel face wipes can soothe irritated haemorrhoids. They’re available at supermarkets and pharmacies. Steroid creams containing 1% hydrocortisone reduce inflammation and can be used outside your anus but not inside. Use them for short periods only or as directed by your doctor.

You can also buy ointments from your pharmacy containing a local anaesthetic to numb the pain. Combination haemorrhoid products containing pain relievers plus ingredients that shrink haemorrhoids are also available.

Less invasive procedures

Although surgery is the ‘gold standard’ for treatment of haemorrhoids, there are less invasive procedures that can be done in your doctor’s office with less discomfort and a shorter recovery time.

Treatment options for internal haemorrhoids depend on the grade of haemorrhoid.

Learn more about grades of haemorrhoids.

These procedures are worth discussing with your doctor:

Injections

Injecting your haemorrhoid is the simplest and easiest treatment for persistent internal haemorrhoids. Your doctor can inject them with a mixture of phenol and almond oil. This method irritates the blood vessels in the haemorrhoid and creates a clot. It’s a simple procedure without much discomfort because there are no pain receptors in the area. However, the results are unpredictable and the haemorrhoids may recur.

Injections are a good way to treat small haemorrhoids and cause very little discomfort.

Rubber band ligation

A rubber band is placed around the base of your haemorrhoid. The band cuts off blood circulation and the haemorrhoid withers away within a few days. It’s generally done for large internal haemorrhoids and prolapsing haemorrhoids.

The procedure is relatively safe and usually painless but may need to be repeated more than once. No anaesthetic is needed. Very occasionally, an artery supplying a haemorrhoid ruptures, which can result in heavy bleeding.

Coagulation

For small to medium-sized internal haemorrhoids, coagulating the blood supply to your haemorrhoid can be effective. This can be done with infrared rays, laser therapy or cryotherapy (freezing). Scar tissue forms and cuts off the blood supply to the haemorrhoid. However, this type of treatment doesn’t have a high success rate and improvements may not be permanent. Only one haemorrhoid can be treated at a time, so a repeat procedure is required if you have several. If coagulation is not performed expertly, the associated post-treatment pain can be severe and prolonged.

Laser coagulation is no better than infrared, takes longer and may cause more scarring.