Haemorrhoid Health Check

Frequently Asked Questions

Can I choose which consultant I see?

Absolutely. Self-funding your treatment enables you to choose when you are seen, and who you are seen by. King Edward VII’s Hospital consultants are among the finest in the UK, so you can be sure you are choosing one of the best for your condition.

The list of available haemorrhoid consultants for  health checks are on this web page.

Is the price fixed irrespective of how complex my rectal problem is?

The price for the health check is fixed and includes taking a comprehensive history, performing a clinical examination and proctoscopy, as well as formulating a suggested treatment plan.

The cost of treatments is not included in the health check and will vary depending on how complex your problem is. However, if more complex investigation is required, there might be a supplemental cost.

Can I use my private medical insurance?

If you have private medical insurance, you can still choose when you are seen and who you are seen by, from the same list of outstanding specialists.

The booking process is a little different. This ‘package’ price has been created for self-funding patients only and is not applicable to patients with private medical insurance.

However, if you have private medical insurance, the costs of consultations, diagnostics and treatment should be covered. Check with your insurance provider that your condition and chosen consultant’s fees are covered as you may have to pay an excess or shortfall, and obtain pre-authorisation before booking. Your insurance provider will likely require a GP referral too.

If you need any help with the process, our team is always on hand. Please call 020 7467 4344.

Do I need a GP referral?

You do not need to have a GP referral for a haemorrhoid health check, although it would be useful to have one.

How long will the haemorrhoid health check take?

The health check will take 30 minutes.

What happens during a haemorrhoid health check?

Your consultant will take a thorough history to determine what your symptoms are, how they affect you and what your treatment priorities are. They will also check if you have any underlying medical conditions and what regular medication you take, as these may affect what treatments are available to you.

You will then be asked to undress the lower half of your body and lie on an examination couch on your left side in a foetal position. The consultant will shine a light on your bottom and inspect the anal area. They will then perform a gentle rectal examination, where a lubricated finger is carefully inserted into the anus to feel for any abnormalities. They will then move on to a proctoscopy, where a single patient use disposable plastic telescope, which is about the same size as a finger, is gently inserted into the back passage and then withdrawn slowly.

Internal haemorrhoids can only be diagnosed on proctoscopy, as they are not palpable or visible from the outside.

What is a proctoscopy?

During proctoscopy, a single patient use disposable plastic telescope with an inbuilt LED lightsource, which is roughly the same size as a finger and much smaller than an average sized stool, is lubricated and gently inserted into the back passage. It is then withdrawn slowly, allowing the consultant to see the size and anatomical location of internal haemorrhoids and other abnormalities, such as the internal openings of anal fistulas or fibroepithelial polyps inside the anal canal.

Do I need to prepare for a haemorrhoid health check?

You do not need to prepare for the haemorrhoid health check. Don’t worry about whether or not you have opened your bowels before the assessment – this makes very little difference to the assessment.

What do I wear for a haemorrhoid health check?

Wear comfortable clothing that is easy to remove when undressing the lower half of your body.

What are the potential treatment options?

If you have haemorrhoids, a number of procedures are available to you. For internal haemorrhoids, some minimally invasive treatments such as injection sclerotherapy, rubber band ligation and the Rafaelo procedure are available. These can be performed either in the clinic room or in the endoscopy department under light sedation.  External haemorrhoids usually need a formal haemorrhoidectomy and circumferential haemorrhoids may be treated with a THD or HALO procedure.

In general, there is a trade-off between effectiveness and pain – the more effective a procedure, the more painful the recovery. For example, a formal haemorrhoidectomy is the most painful procedure but also has the lowest rate of recurrence of the haemorrhoids. Injection sclerotherapy is the least painful, but has the highest recurrence rates. The other treatments lie somewhere in-between. Your surgeon will help you to strike the right balance between effectiveness and post-procedure pain when selecting the procedure that is right for you. This is a highly individual decision, which is why it is important to see an experienced consultant who knows all the treatment options and is able to assess your needs and priorities in a thorough and sensitive manner.

Anal skin tags and anal warts are usually removed under general anaesthetic. If you have an anal fissure, this is initially treated with topical creams but sometimes an injection of Botox under general anaesthetic is required. If you have an anal fistula, a wide variety of treatments are available to treat this depending on the complexity of the fistula – your consultant will discuss these with you.

If I need an operation, will it be done by the consultant who sees me?

Yes, absolutely. Self-funding your treatment enables you to be seen by the same specialist from your very first meeting, to your operation, to your follow up consultation. It is still your choice, and there is no obligation to see the same consultant, but you should be aware that if you choose to see another specialist, they will require you to have an initial consultation prior to any surgery.