Haemorrhoidal disease is the most common proctological disease in Western countries. About 50% of the people above 50 years of age that live in industrialized countries are estimated to suffer or to have suffered from symptoms associated with haemorrhoidal disease.
Before treating haemorrhoids, a thorough clinical assessment should be performed, since a wide range of treatment options is now available. Depending on the severity of both the disease and the symptoms, physicians can choose among medical treatments, out-patient surgery/ day-surgery, and conventional surgery with a longer stay in hospital.


Haemorrhoids are swollen veins in the lower rectum or anus.  By age 50, about half of the population will have experienced this sometimes painful condition, which results from an increase in pressure inside the veins of the rectum.  Common causes include constipation, pregnancy, childbirth, obesity, heavy lifting, sitting for long periods and diarrhea.
There are two types of haemorrhoids based on location.  Internal haemorrhoids occur inside the lower rectum and often can’t be seen or felt.  As this form is typically painless, the only symptoms you may notice are small amounts of bright red blood (on your toilet paper or inside the toilet bowl) or a feeling of fullness following a bowel movement. 
Occasionally, internal haemorrhoids can push through the anal opening.  This is known as a prolapsed, or protruding, hemorrhoid.  Sometimes these swollen veins remain prolapsed temporarily; in other cases, they become permanent.  If the haemorrhoid remains outside the anus, it can cause pain, itching, bleeding and the formation of excess skin (skin tags).
External haemorrhoids occur as bulges or lumps around the anus.  Because of the sensitive nerve fibers in this area, these enlarged veins are often painful, especially when sitting.  They also may bleed and itch.  Should blood pool in an external haemorrhoid, a blood clot referred to as a thrombosed haemorrhoid may develop and cause severe pain.



THD - A painless surgical procedure to treat haemorrhoids
Transanal haemorrhoid dearterialization is the least invasive surgical technique to treat haemorrhoids, as it implies no tissue excision. A few internal stitches are given on the rectal mucosa, in an area where there are no sensory innervations.
For this surgical procedure a doppler is used to locate the terminating branches of the haemorrhoidal arteries. Once the artery is located, the surgeon uses an absorbable suture to ligate or "tie-off" the arterial blood flow. If haemorrhoids are prolapsed, a hemorrhoidopexy is performed to repair the prolapse and to "lift" the tissue back to its anatomical position.