My 10-minute op ended 20 years of piles torment
THREE-QUARTERS of us suffer from piles or haemorrhoids (swollen tissue and blood vessels in the back passage) at some stage. Now a simple procedure done under local anaesthetic in just minutes could eradicate them. Mother-of-two Dharmistha Patel, 43, from
SInCE I was pregnant with my daughter 20 years ago, I have suffered from haemorrhoids. Some days, especially if I felt stressed, I was in constant pain, with a lot of bleeding.
I went to see my GP for a referral to a specialist and was told the only answer was complicated surgery. This would have meant a long, painful recovery and at the time I had my children to look after and I ran a business with my husband, Ashok, and could not afford the time off work.
my symptoms would flare up for a few days and then fade again. Every time I felt I had to get them sorted, they seemed to get better, so I didn’t think it was worth having surgery. I never tried over-thecounter remedies as I knew they wouldn’t cure the root cause.
I have always been healthy and love exercising, but the piles made yoga, Pilates and gym classes difficult. I would ask Ashok to lift anything heavy. It was depressing, but, like many of my friends (particularly the mums) who had them, I just got on with it.
Ashok always nagged me to see a specialist to have surgery, but the more he pushed me and the older I got, the less I wanted it done.
After a painful summer, I couldn’t put it off any longer and saw a specialist privately. I was told about a new option called Halo where the piles are stitched to cut off the blood supply rather than cut out. It looked like a less painful option so I booked to have it done.
But while waiting for that appointment I read about a newer procedure called Rafaelo and arranged another consultation.
The consultant explained that Rafaelo is quicker than Halo and can be done without a general anaesthetic. He said it involved using radiofrequency energy to shrink the piles in minutes. So I agreed to cancel the Halo procedure and have Rafaelo instead.
TEn
days later, I had it done with local anaesthetic. I couldn’t feel anything except a slightly warm sensation. It was over inside ten minutes and I left hospital an hour later, feeling no pain at all.
The next morning I told the consultant it felt like a dream — no pain, no bleeding, nothing. It was the first time in 20 years that I’d felt like this.
I’m back doing yoga, Pilates and lots of gym classes. I can also lift anything heavy and I’m not in discomfort at all. Nick West is a consultant colorectal surgeon at spire st Anthony’s Hospital in cheam, surrey, and st Helier University Hospitals NHs trust. HAEmoRRHoIdS, also known as piles, are essentially swollen blood vessels that can occur inside and around the bottom.
The lining of the area contains a network of small veins, and for various reasons these become wider and fill with more blood than usual.
They can be caused by anything that increases pressure in the abdomen and are commonly seen in pregnancy, chronic constipation, and are often caused by a diet lacking in fibre.
Haemorrhoids come in different grades according to their complexity, which depends on their location and the number and size of the blood vessels involved.
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. The piles then wither. 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.
It is the same technology used to cauterise varicose veins and to treat liver and lung cancer.
Last year, I was approached by the parent company that developed the radiofrequency treatment for varicose veins to see if it could help remove piles, too.
It can be used on all but the most severe, external haemorrhoids. For those, surgery is the only option.
To carry out Rafaelo, the patient lies on their side and local anaesthetic is injected into the anus.
Then a small scope is inserted to pinpoint where the piles are. A fine metal probe is passed down the scope and directed at the pile. It then emits radiofrequency waves that destroy the pile instantly.
It takes less than five minutes, the patient feels only a slight warm sensation and is able to leave hospital within an hour or two.
If there is any discomfort, the patient is given painkillers, but most often, as in mrs Patel’s experience, that isn’t necessary.
Because I’m using the same technology used by vascular surgeons for other health issues, we know it’s safe.
Radiofrequency treatment for varicose veins is increasingly common and available on the nHS. It’s my vision Rafaelo will be offered on the nHS for piles in time.
THE RISKS?
AS WITH any piles procedure, there is a low risk of bleeding.
There is also a low risk of infection and slight discomfort.
neil Cripps, a consultant colorectal surgeon at the Western Sussex Hospitals nHS Foundation Trust, says: ‘Rafaelo sounds as if it will be of benefit for haemorrhoids that bleed and prolapse, but don’t have large elements outside the anal canal.
‘Any effective procedure that doesn’t involve a general anaesthetic and allows a patient to get on with their life more quickly has to be a significant advance.
‘Like any new procedure, we need more clinical data before we can make any scientifically based claims, but it seems to be a promising new development.’
Vascular surgeon mark Whiteley of the Whiteley Clinic adds: ‘The early results from Rafaelo appear to be very good.
‘It will be interesting to see how much improvement it can make to patients long term compared with traditional methods. I suspect the results will be good and patient satisfaction will be high.’
THE PATIENT THE SURGEON