Haemorrhoids are considered to be internal or external:

  • Internal haemorrhoids are collections of blood vessels, which form into “3 cushions” in varying positions within the anal canal.
  • External haemorrhoids are really small skin tags that protrude from the anal verge.


  • The most common symptom of haemorrhoids is bright bleeding during and after a bowel motion.
  • Internal haemorrhoids may also prolapse (protrude) and cause some degree of discomfort and irritation.
  • External haemorrhoids may make cleaning the anal area difficult and also act as a source of irritation.
  • Occasionally a blood vessel may burst under the skin and cause a painful and swelling which is referred to as a thrombosed external haemorrhoid or perianal haematoma. This latter condition is common in athletes or individuals who may strain excessively at stool. It is a self-limiting condition, but may often be improved by a minor procedure, which can be undertaken in the office.

Thrombosed prolapsed haemorrhoids refers to the complications of internal haemorrhoids, which may tend to protrude from the anus after a bowel motion and not return to the lower part of the bowel. This painful and distressing condition sometimes requires semi-urgent operation.


  • The treatment of haemorrhoids depends on their severity.
  • Symptoms from haemorrhoids may improve by an increased amount of fibre in the diet.
  • Ointments and suppositories may also be helpful.
  • Large haemorrhoids may require some injection treatment or the use of elastic bands. A more recent treatment - Doppler Guided Haemorrhoidal Artery Ligation might be appropriate. Very large haemorrhoids may require haemorrhoidectomy (operation).
  • Freezing, infrared and laser therapy to haemorrhoids are just differing methods of using energy to remove a haemorrhoid. They have no particular advantage over “normal” haemorrhoidectomy.
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