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Getting to the bottom of PILES; More than half of us will suffer from haemorrhoids at some point, yet most people are too embarrassed to seek help. Consultant surgeon Nick West, who specialises in this delicate area, tells us what we need to know.


They're an enlarged version of the vascular 'cushions' we have inside our back passage to help control bowel movements. You can't always tell you have piles by looking, because they are often hidden internally, but they often form as around lump that's dark blue or purple in colour because of the restricted blood flow. 'If you have pain or bleeding, see your GP to rule out anything more sinister,' says Mr West. 'Don't let embarrassment put you off. Whatever you have, we'll have seen it before. The earlier you seek help, the easier piles are to treat.'


They're caused by an increase in pelvic pressure.

Common triggers are pregnancy, constipation and spending a long time straining on the loo. Contrary to myth, they are NOT caused by sitting on cold or hard surfaces.

How are they treated?

Piles often disappear on their own and only need treating if they are causing uncomfortable symptoms, says Mr West. 'Look at your diet and toilet habits first. That might be all you need to get rid of them. Creams from chemists don't cure piles, but they will ease itching and inflammation until they hopefully clear up spontaneously.' ?

What if they don't go away on their own?

For persistent piles, the NHS offers several options performed under local anaesthetic. Banding involves placing a tight elastic band around haemorrhoids to cut off their blood supply. Another option is sclerotherapy, which injects a chemical solution into the haemorrhoid, making it harden then shrink and die. In the most severe cases, haemorrhoids can be surgically removed under general anaesthetic. Although very successful, there's a painful downtime of 2-4 weeks.


Rafaelo is a new, privately available treatment that destroys piles in 15 minutes using radiofrequency. It's done under local anaesthetic or sedation. 'A probe is inserted into the haemorrhoid, and radiofrequency energy makes it shrink and disappear,' says Mr West. 'The downtime is minimal and patients go home the same day. I've used it successfully with patients who would otherwise have needed surgery.' Piles are graded 1-4, and Rafaelo is suitable for grades 1-3, but grade 4 will likely need surgical removal.

'It was the size of a queen olive' Alison*, 28, had treatment with Mr West after suffering with piles for years 'It was a shopping trip I'll never forget. I felt a horrible pain in my bottom and when I looked in the mirror I saw blood all down the back of my cream trousers. I didn't even have a coat to hide it. I fled home, humiliated. I'd had piles on and off for years, but now it'd reached the point where I was bleeding daily, and the piles would often prolapse and pop out. I'd try to avoid going to the toilet because I dreaded the pain. Even sitting down could be very uncomfortable.

I spent a lot of time with a mirror between my legs, trying to see what was going on. I'd avoid having sex with my partner if I was having a bad episode. Piles are absolutely not the thing to make you feel sexy.

I spent a lot time Googling treatments, and that's when I came across Rafaelo. The thought of a consultation was mortifying but Mr West was very professional and there was a female chaperone in the room. After being examined, he told me I had two internal haemorrhoids. The largest was the size of a queen olive! I was so happy when he told me the treatment would work for me.

The treatment only took 30 minutes with sedation. When a nurse handed me a glass of water afterwards, I thought I was still waiting to be put to sleep.

That night, the discomfort from the treatment was mild - it was nothing like the constant pain I'd been used to for years. I was nervous the first time I went to the toilet but it didn't hurt.

In fact, since the day I had the treatment I've had no symptoms whatsoever. Not having to worry about piles any more has totally changed my life.' Keep piles at bay b laxat bowel lazy, says BioCare ad more water and ea vegetabl exercise, s inclu prob Avoiding constipation can help prevent piles but over-reliance on laxatives can make the clinical nutritionist Seema Varkaria. She advises drinking eating a diet high in fruit, vegetables and fibre. Daily abdominal massage and supplements including prebiotics, probiotics and psyllium husk can also be helpful.
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Title Annotation:Features
Publication:The People (London, England)
Date:Feb 25, 2018
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