These are treatments that you can have in an outpatient clinic.
Banding (Rubber band ligation)
This is used mostly for second and third degree piles, but you can also have it if self-help treatments haven’t worked for your first degree piles.
Your doctor will place a small elastic band just above the pile. This will cut off the blood supply to the pile, causing it to die and fall off after a few days. The raw area left behind will heal up naturally.
Cryosurgery freezes the pile to destroy it. It is not used much, because it causes a watery discharge afterwards.
Infrared coagulation uses infrared light to destroy the pile. This method is not commonly used, because it is not as effective as other methods.
This is an injection of an oily solution known as a sclerosant into first or second degree piles. The oil causes the pile to shrink and fall off.
These are treatments that you have in hospital. You may need to stay overnight so that your doctors can monitor your progress afterwards.
This is the surgical removal of piles. Your doctor may suggest a haemorrhoidectomy if you have third or fourth degree piles, or if banding or sclerotherapy hasn’t worked.
The operation is done under general anaesthetic. This means you will be asleep during the operation and feel no pain. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
Your surgeon will cut the pile away from the muscle underneath and tie off the blood vessels to prevent bleeding. The exposed wound area will then heal naturally. Your surgeon may use stitches to close the wound.
This is a newer surgical technique that involves removing a doughnut shaped piece of tissue to lift up the anal cushions, preventing them from prolapsing. Because a stapling instrument is used to join the two sides of the resulting wound, the operation is also called a stapled haemorrhoidectomy (PPH, Procedure for Prolaps and Haemorrhoids, op sec Longo).