Mild disease may be treated conservatively with dietary fiber, intake of adequate oral fluids, topical anti-inflammatory agents and suppositories, sitz baths etc.
Surgery is indicated if conservative measures fail to control symptoms.
A number of surgical techniques have evolved, such as classical haemorrhoidectomy (Miligan-Morgan), stapled haemorrhoidectomy (Longo) and, more recently, Doppler-guided Transanal Haemorrhoidal Artery Ligation. The latter is a minimally-invasive procedure that uses doppler technology to accurately identify the arterial blood supply to the haemorrhoids. Subsequently, the arteries are “tied-off” and the haemorrhoids “shrink” and eventually disappear in the next 2-3 weeks. It is a very successful, safe, painless and bloodless procedure with minimal complications. Patients can usually return home on the same day following surgery.