New procedure cuts pain, recovery time for haemorrhoids patients

Haemorrhoids affect about 4.4 per cent of people globally. [iStockphoto]

For decades, haemorrhoids, commonly known as piles, have remained one of the most uncomfortable and quietly endured medical conditions among many Kenyans. Often dismissed as a minor or embarrassing problem, the condition affects thousands of people, causing pain, bleeding, itching and, in severe cases, anaemia and infections.

What once required painful surgery, days of hospitalisation and weeks of recovery can now be treated through a procedure that takes only a few hours, allowing patients to be discharged on the same day.

Kenyatta National Hospital (KNH) is adopting Transanal Haemorrhoidal Dearterialisation (THD), a minimally invasive technology designed to treat haemorrhoids with greater precision while minimising tissue damage.

The technology combines ultrasound guidance with specialised stitching techniques to identify problematic blood vessels before treatment. According to the hospital, this enables surgeons to target only the affected areas while preserving surrounding tissue.

Haemorrhoids are swollen and enlarged veins in the lower rectum or around the anus, similar to varicose veins. They may occur internally within the rectum or externally beneath the skin around the anus. Although generally benign, they can cause significant discomfort and negatively affect a person’s quality of life.

KNH says haemorrhoids remain a common condition in Kenya, with many patients requiring surgical intervention. The adoption of THD is expected to improve outcomes through shorter hospital stays, faster recovery and an enhanced patient experience.

Dr Kennedy Ondede, a surgeon and Director of Surgical Services at KNH, said haemorrhoids have traditionally been treated through various methods, including open surgery, stapling, banding, laser procedures, injection of sclerosants and medication.

“The introduction of THD technology at KNH offers a modern and minimally invasive alternative with several advantages, including reduced pain after the procedure, faster recovery and return to normal activities, reduced bleeding, minimal surgical wounds, shorter hospital stays and a lower risk of complications such as infection, anal narrowing and incontinence,” said Dr Ondede.

“The THD procedure uses a Doppler-guided instrument to identify and tie off arteries supplying blood to the haemorrhoids, thereby reducing swelling and symptoms without extensive tissue removal,” he added.

Common causes of haemorrhoids include straining during bowel movements, chronic constipation or diarrhoea, prolonged sitting on the toilet, pregnancy, obesity, low-fibre diets and heavy lifting.

“Haemorrhoids are not cancerous. They are benign conditions, but they can become a major nuisance. They may cause pain, persistent itching and bleeding. In severe cases, bleeding can lead to anaemia, while infections can further complicate the condition. That is why they must be managed appropriately,” he said.

Dr Ondede noted that prevention remains the best approach. Avoiding straining during bowel movements and ensuring stools remain soft can significantly reduce the risk of developing haemorrhoids. “Any activity that puts excessive pressure on the rectal area should be avoided,” he said.

Common investigations include proctoscopy and colonoscopy, which help doctors rule out other conditions that may mimic haemorrhoids.

“We have to examine the entire colon because other conditions, including rectal cancer, can interfere with blood flow and produce symptoms similar to haemorrhoids,” he explained.

Open surgery, one of the oldest treatment methods, involves removing the swollen haemorrhoid using a surgical blade. While effective, it is often associated with considerable pain, bleeding, difficulty passing stool and prolonged recovery periods.

Over the years, less invasive alternatives have emerged. One such method is banding, where a haemorrhoid is suctioned into a device that places a rubber band around it, cutting off its blood supply and causing it to shrink.

Stapling involves using a specialised surgical device to reposition and remove haemorrhoidal tissue while applying staples. Although less painful than open surgery, it is considerably more expensive. “Most of these procedures interfere with the anatomy of the anal region, which contains important sphincter muscles responsible for controlling bowel movements. Damage to these structures can result in severe pain or faecal incontinence,” Dr Ondede said.

By contrast, THD preserves the anatomy of the rectal and anal area. “It allows us to identify the three main columns of blood supply to the anorectal region and selectively tie off the affected vessels. It is a day procedure, causes less pain, results in minimal bleeding and is affordable,” he said.

Dr Ondede added that THD is also more cost-effective than some conventional procedures. The procedure costs about Sh40,000, while stapling equipment alone can cost between Sh50,000 and Sh80,000. “On average, we operate on eight to 10 patients with haemorrhoids every week at KNH,” he said.