A new minimally invasive embolisation procedure to treat haemorrhoidal disease, which impacts the lives of many South Africans, was recently performed for the first time at Netcare hospitals in Johannesburg and Cape Town and is now being offered as a standard treatment option.

Specialists like Dr Maja Wojno (left) and Dr Gary Sudwarts (right) will commonly first treat haemorrhoid disease using a rubber band over the enlarged haemorrhoidal vein. Eventually, however, some patients require surgical removal of haemorrhoids.

Interventional radiologists Dr Gary Sudwarts and Dr Maja Wojno successfully performed the newly introduced rectal artery embolisation procedures at Netcare Park Lane Hospital and at UCT Private Academic Hospital (UCTPAH) recently. Dr Sudwarts says that the intervention has shown most promising results internationally in the treatment of haemorrhoids since it was first introduced overseas in recent years.

“This approach, which has a number of advantages over the surgical removal of haemorrhoids, including that it is painless and recovery times are greatly reduced, is showing itself to be an invaluable new treatment option for haemorrhoidal disease patients in South Africa,” said Dr Sudwarts.

“Pleasing outcomes have been achieved globally with the minimally invasive embolisation procedure, which involves blocking the blood vessels that are supplying the haemorrhoids with blood, causing them to shrivel and die. The procedure is safe and has achieved a meaningful reduction in symptoms and improved quality of life for patients,” noted Dr Sudwarts and Dr Sudwarts, who practises at Netcare Park Lane Hospital in Johannesburg and UCT Private Academic Hospital in Cape Town.

He is now offering the procedure as a standard treatment option to appropriate patients. Haemorrhoids may become debilitating and a medical problem when they are persistently swollen, causing pain, bleeding and/or severe itching in the anus. It is estimated that half of the population will experience the condition at some point in their lives.

While most cases of haemorrhoidal disease are not serious and symptoms often go away on their own or can be easily managed through an improved diet and lifestyle and the use of prescribed and over-the-counter medicine, they may in some cases swell significantly and cause incapacitating symptoms.

Such cases may require surgical intervention particularly in patients in whom bleeding is the main symptom. “Specialists will commonly first treat haemorrhoid disease using a rubber band over the enlarged haemorrhoidal vein. Eventually, however, some patients require surgical removal of haemorrhoids.

Haemorrhoidectomy has traditionally been a standard treatment approach for more serious cases of this condition, although ultrasound guided interventions and other approaches are also available today. As the anus is a highly sensitive area, the haemorrhoidectomy can be extremely painful and recovery can take two weeks or more. In addition, in some cases the haemorrhoids can re-occur.

“On the other hand, the embolisation procedure is a safe day procedure used in cases of severe and persistent haemorrhoid disease causing uncomfortable and debilitating symptoms and may also be considered for patients for whom surgery is not an option due to other co-morbidities. Patients are discharged home the day of the procedure and tend to recover much quicker and report little or no post-operative pain,” said Dr Sudwarts.

Haemorrhoid disease is often linked with persistent constipation or diarrhoea, obesity, poor posture, too much sitting, previous surgery on the rectum, cancer and sometimes pregnancy. External haemorrhoids protrude from the anus and may need to be pushed back in after a stool has been passed and can be prone to secondary skin infections.

According to Dr Sudwarts, persistently swollen haemorrhoids can cause severe discomfort and pain. In some cases, they may be a symptom of a more serious underlying medical condition. Medical practitioners need to investigate the cause of rectal bleeding or if there is an underlying condition that is causing the haemorrhoids to enlarge.

“While there remains a need for studies to assess the long-term effectiveness of the haemorrhoidal embolisation technique, the fact that it is safe, painless and is showing good short-term results, is making it an increasingly popular option internationally. We are excited to be offering the new minimally invasive option in South Africa,” concluded Dr Sudwarts.