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Often there are no symptoms, but as a large proportion of the population knows — around 75 per cent of adults, according to latest data — they can cause itching, bleeding and discomfort. Many people with haemorrhoids don’t seek professional help because of embarrassment or the fear of surgery. One common treatment for piles is banding, where an elastic band is looped around the piles to cut off the blood supply. While this is quick, the piles can return and patients often need further treatment. Until a few years ago, if your piles were too severe for banding, you might have a haemorrhoidectomy, an operation in which the piles are cut out. While effective, this requires a general anaesthetic and leaves patients with an open wound. It can take weeks to heal, meaning time off work and taking painkillers and laxatives to ease the passage of stools. Around five years ago, surgeons developed the Halo and THD procedures, which use an ultrasound probe to locate the arteries supplying the pile and then it is stitched to stop the blood flow. Once the blood flow is stopped, the pile will shrink and over the next few days will disappear. The piles are far less likely to return than with banding. These procedures are a lot less painful than a haemorrhoidectomy, but are still done under a general anaesthetic and patients need a day or two off work to recover. Now we offer a procedure called Rafaelo, which was pioneered in Poland and Belgium last year. This uses radiofrequency energy to burn away the pile. The main advantage is that Rafaelo doesn’t require a general anaesthetic, can be performed as a day-case procedure and patients can get back to their normal lives much faster.

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