The hemorrhoid itself
What you notice
In the office
Surgical options
What it costs
Getting started
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Where we see people
Get in touch
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Hemorrhoid clinic
Most people arrive having already tried a cream for months. The useful question is not which cream, it is which grade, and whether the bleeding has been looked at properly. Both are settled at the first visit.
What we treat
Bleeding, a lump and itching cover almost every first appointment. What is behind them differs, and so does what settles them.
Graded one to four by how far they have moved; often painless, but they bleed.
Learn moreFormed under the skin around the anus, where they can be felt and often hurt.
Learn moreA clot inside an external hemorrhoid: a firm bluish lump that arrives suddenly.
Learn moreAn internal hemorrhoid that has come down, and whether it still goes back.
Learn moreBright red bleeding is assessed here, never assumed to be the obvious answer.
Learn moreA tear that is sharply painful on passing stool, and is not a hemorrhoid at all.
Learn moreGrades, not creams
Internal hemorrhoids are graded one to four, and the grade is what decides the options. Grades one to three that have not settled with conservative care are the ones office procedures are built for. Grade four, and anything with a clot in it, is a different conversation entirely.
That is why the first visit is an examination rather than a prescription. An anoscope shows which columns are involved and how far they have moved, and that is not something a photograph or a description over the phone can settle. Our examination page walks through what it involves.
Once the grade is known the choice narrows quickly, usually to banding, infrared coagulation or, for the few presentations that need it, surgery. What you will not get is a cream prescribed for something nobody has looked at.
How it works
A sentence about bleeding, lumps or itching and how long it has gone on. A clinician reads it before you arrive.
History, an external look and an anoscope examination, then the grade and the options stated plainly rather than hinted at.
Banding, infrared coagulation or sclerotherapy, in a clinic room, in minutes, with no general anaesthetic needed.
A follow-up to see what settled and whether another column needs treating, plus what to change so it does not return.
Bleeding
Bright red bleeding with no pain is commonly hemorrhoids. Commonly is not always, and the same symptom appears in conditions that matter a great deal more. Blood mixed through the stool rather than sitting on the surface, bleeding that keeps returning, a change in stool shape, or unexplained weight loss all move the question elsewhere.
So the clinic does not treat bleeding on description. It assesses it, and says plainly when something needs a colonoscopy or a referral rather than a band. The red flags page lists what we will not treat without looking further, and the bleeding page explains what the examination looks for.
This is slower than being told it is nothing, and it is the part of the visit that matters most. If you want to know what the appointment itself involves, start here.
Common questions
The questions people ask before they book, answered the way a clinician would answer them in the room.
How we work
An anoscope examination happens at the first visit, because the grade decides the options and a description cannot settle it.
Published figures for the same procedure vary by a factor of five. You get your own number, from your plan and your session count.
Some bleeding needs a colonoscopy or a specialist rather than a band. You hear that at the first appointment.
Session counts and intervals are given as ranges because the sources themselves disagree, and a single figure would be invented.
Get started
Tell us what the symptoms are and roughly how long they have gone on. A clinician reads it before your appointment, so the visit starts with the examination rather than with the form.
If what you have is not something we should be treating, we will say so at the first visit.