Haemorrhoid Banding. Exceptional healthcare, personally delivered

Transcription

1 Haemorrhoid Banding Exceptional healthcare, personally delivered

2 Introduction This leaflet describes what haemorrhoids are and what causes them. It discusses lifestyle changes to avoid them as well as details of haemorrhoid banding including risks, benefits and aftercare. Haemorrhoids (piles) Haemorrhoids (piles) are enlarged blood vessels in the lining of the anus and lower rectum (back passage). These can become irritated causing bleeding, itching, discomfort, and sometimes can protrude from the back passage. Haemorrhoids are often small and symptoms settle down without treatment. But there are times when treatment is required. What causes them? About half the people in the UK develop one or more haemorrhoids at some stage. Certain situations increase the chance of haemorrhoids developing. Constipation, passing large stools (faeces) and straining at the toilet. These increase the pressure in and around the veins in the anus and seem to be a common reason for haemorrhoids to develop. Pregnancy. Haemorrhoids are common during pregnancy. This is probably due to the pressure effects of the baby lying above the rectum and anus and the effect that changes in hormones during pregnancy can have on the veins. Aging. The tissue in the lining of the anus may become less supportive as we get older. Hereditary factors. Some people may inherit a weakness of the wall of the veins in the anal region. 2 Haemorrhoid Banding

3 What is the treatment for haemorrhoids? Keep the faeces (sometimes called stools or motions) soft and don t strain on the toilet. You can do these by the following: n Eat plenty of fibre such as fruit, vegetables, cereals and wholemeal bread etc. n Have lots to drink. Adults should aim to drink at least two litres (10 12 cups) per day. You will pass much of this fluid as urine, but some will be passed out in the gut and softens faeces. Most sort of drink will do but alcoholic drinks can be dehydrating and may not be so good. n Avoid painkillers that contain codeine such as co-codamol as they are a common cause of constipation. n Toileting. Go to the toilet as soon as possible after feeling the need. Some people suppress the feeling and plan to get to the toilet later. This may result in bigger and harder faeces forming which are more difficult to pass. Avoid constipation and straining at the toilet. Banding Treatment Banding is a common treatment for haemorrhoids. It may be used to treat haemorrhoids which have not settled with the measures above (such as increase in fibre etc). A surgeon in the outpatient clinic usually does this procedure. A suction device grasps each haemorrhoid and a rubber band is placed at the base which cuts of the blood supply to the haemorrhoid. This causes the haemorrhoid to shrink leaving the dead tissue to drop off over a period of up to 10 days. Banding of internal haemorrhoids is usually painless as the base of the haemorrhoid originates above the anal opening the very last part of the gut lining is not sensitive to pain. Up to three haemorrhoids may be treated at one time using this method. Haemorrhoid Banding 3

4 Benefits In about 8 in 10 cases the haemorrhoids are cured by this technique. In about 2 in 10 cases the haemorrhoids recur at some stage. However, you can have further banding treatment if this occurs. Haemorrhoids are less like to recur after banding if you do not become constipated and do not strain on the toilet as described earlier. Risks A small number of people have complications following banding such as bleeding, urinary problems, infection or ulcers forming at the site of a treated haemorrhoid. If you see a lot of fresh bright red blood or pass clots you should seek urgent medical attention. What to expect with Haemorrhoid banding recovery. When haemorrhoid banding is finished, expect to feel: n Pain from anywhere from 24 to 48 hours. n The sensation of fullness in the lower abdomen. n That you need to have a bowel movement. You may also find it difficult to urinate and to control gas or bowel movements for a few days. Also expect to have bleeding for up to 14 days after the treatment. The bleeding may get worse at 7 10 days when the banded haemorrhoid drops off. The wound normally takes about two weeks to heal. However, you will have no more itching, painful, bleeding haemorrhoids. Aftercare You may experience some discomfort after the banding. You should take regular painkillers such as paracetamol if you need to. Avoid strenuous exercise for the rest of the day, e.g. avoid sport, jogging or riding a bike. 4 Haemorrhoid Banding

5 You can bath or shower as you wish. You should be able to get back to your normal life the next day. If you need a follow up appointment in clinic it will be arranged at the time, or often you can be referred back to your GP. References Haemorrhoids. Clinical Knowledge Summaries. Available at [Accessed June 2009] Acheson, AG and Scholfield, JH Management of haemorrhoids. BMJ. Feb 16: 336 (7640) Brsinda G Prevention is best; haemorrhoidectomy needs skilled operators. BMJ. Sep 9; 321 (726) NICE 2007 Haemorrhoid- stapled haemorrhoidopexy. Available at [Accessed June 2009] NHS Constitution. Information on your rights and responsibilities. Available at Haemorrhoid Banding 5

6 If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published May Review due May NBT002106