Haemorrhoids occur when the anal cushions become enlarged . Around 50 per cent of us will suffer from piles (or haemorrhoids) - swollen tissue and blood vessels in the back passage. Lis Jackson, 57, a paediatric secretary and mother-of-four from Inverness, took part in a study to determine the best way of treating this common problem, as she tells DIANA PILKINGTON. Piles have troubled me since the birth of my second child, Janine, who's now 35. At first it was just a bit of discomfort when I went to the loo. Occasionally, the piles would stick out, but I'd just push them back and put up with it. Over the years it got worse, though. A decade ago the piles had prolapsed to the point where I couldn't push them up. They'd bleed, and were getting more painful and itchy. I finally decided to take action three years ago after a test under the NHS bowel cancer screening programme found blood in my stool (which can be a symptom of cancer), and I had to submit another sample. The second test was clear, but it spurred me to see my GP about the piles. A prescription haemorrhoid  ointment, Scheriproct, relieved the itching, but the bleeding was still there. So, last summer, I had a colonoscopy (where they examine your bowel with a camera on a tube) at Raigmore Hospital in Inverness. This ruled out cancer, but my surgeon Professor Angus Watson said he would treat my piles with a procedure  called banding. They put small rubber bands around the piles, cutting off the blood supply and making them shrink.It didn't help. So at my six-week follow-up, he said I could take part in a trial comparing two other treatment methods. This would involve having traditional haemorrhoidectomy (where they cut off the piles) or stapled haemorrhoidectomy (where they lift the piles back in place and secure the area with titanium staples).I wouldn't know until the day of my treatment which one they'd do, but I didn't mind: I just wanted a solution. On the day of the op, I was told I'd be having the stapling. Back home, I followed post-operative instructions - taking the painkiller co-codamol, laxatives, and warm baths to help ease the pain. The pain lasted a week. More concerning was the urgency I experienced, which meant being within easy reach of a loo. But after three weeks it had all settled down. Now, three months later, the outcome is fantastic and the piles have gone. We're all so embarrassed to speak about these things,  but I just wish I'd had them treated sooner. Stapled haemorrhoidectomy accounts for 20 per cent of all piles surgery . Professor Angus Watson is a consultant colorectal surgeon at NHS Highland and chief investigator of a trial comparing piles treatments, led by the University of Aberdeen. Haemorrhoids occur when the anal cushions - pads of soft tissue, filled with blood vessels, that form part of the watertight seal around the back passage - become enlarged. Common symptoms are pain, bleeding, itching and prolapse - when the piles start to descend through the anal canal. Causes include chronic straining, constipation and pregnancy. Piles can also run in families. They can go away of their own accord. If not, a GP would generally recommend avoiding straining, taking mild laxatives, and eating plenty of fruit and fibre to loosen stools. Creams or suppositories can give some relief. Many contain a steroid which can take away the itch but won't cure the problem. The most common treatment is rubber-band ligation, where bands are placed around the haemorrhoids to interfere with the blood supply and shrink them. A third of patients will get a good result with this. Other treatments are surgical, usually for piles which protrude all the time. In one procedure, excisional haemorrhoidectomy, we remove the piles using a cautery device - a surgical instrument through which an electric current is passed, cutting off the haemorrhoids and sealing the tissue with heat. Stapled haemorrhoidectomy accounts for 20 per cent of all piles surgery. Here, we use a special stapling instrument, around 18in long and 1in wide, to remove a section of the lining of the lower rectum. This allows the protruding haemorrhoids to be pulled back inside the anal canal, and cuts the blood vessels that supply the piles. Then we fire in staples to seal the area. These will either stay in the patient or get passed out during bowel movements. As piles operations are common - 29,000 a year - surgeons need to know the best option for controlling symptoms long-term. So the National Institute of Health Research has given us £1.3 million to carry out a definitive trial across 32 centres. Called eTHoS, it's a comparison of stapled versus excisional surgery. Lis was randomly selected to have the stapling. First the patient is examined under general anaesthetic to check the size of the piles, which can be up to 3cm long. Through a hollow tube, we weave a purse string stitch (which you can pull tight, like a drawstring) into the lining of the rectum just above the piles. We insert the stapler into the rectum and draw the stitch tight, so that it pulls a ring of tissue, about 1cm wide, into the stapler - this has the effect of hoisting the haemorrhoids back into the anal canal. A knife inside the stapler then cuts off the trapped tissue. At the same time, it fires two or three rings of titanium staples to seal off the area. Then we apply local anaesthetic. It takes 20 to 30 minutes - the same as traditional excision. The risks for both methods are the same: pain, post-operative bleeding, and men may have difficulty emptying their bladder, so may need a catheter overnight. Some patients also describe urgency (the body can mistake healing tissue for faecal matter) but that soon settles. At this stage I don't know which technique is better. This trial will help us find out. To find out about taking part in the trial, talk to your GP. Visit w3.abdn.ac.uk/hsru/ethos .
Lis Jackson, 57, a paediatric secretary from Inverness, took part in study .
Aimed to determine the best way of treating this common problem .
Haemorrhoids occur when the anal cushions become enlarged . Around 50 per cent of us will suffer from piles (or haemorrhoids) - swollen tissue and blood vessels in the back passage. Lis Jackson, 57, a paediatric secretary and mother-of-four from Inverness, took part in a study to determine the best way of treating this common problem, as she tells DIANA PILKINGTON. Piles have troubled me since the birth of my second child, Janine, who's now 35. At first it was just a bit of discomfort when I went to the loo. Occasionally, the piles would stick out, but I'd just push them back and put up with it. Over the years it got worse, though. A decade ago the piles had prolapsed to the point where I couldn't push them up. They'd bleed, and were getting more painful and itchy. I finally decided to take action three years ago after a test under the NHS bowel cancer screening programme found blood in my stool (which can be a symptom of cancer), and I had to submit another sample. The second test was clear, but it spurred me to see my GP about the piles. A prescription haemorrhoid  ointment, Scheriproct, relieved the itching, but the bleeding was still there. So, last summer, I had a colonoscopy (where they examine your bowel with a camera on a tube) at Raigmore Hospital in Inverness. This ruled out cancer, but my surgeon Professor Angus Watson said he would treat my piles with a procedure  called banding. They put small rubber bands around the piles, cutting off the blood supply and making them shrink.It didn't help. So at my six-week follow-up, he said I could take part in a trial comparing two other treatment methods. This would involve having traditional haemorrhoidectomy (where they cut off the piles) or stapled haemorrhoidectomy (where they lift the piles back in place and secure the area with titanium staples).I wouldn't know until the day of my treatment which one they'd do, but I didn't mind: I just wanted a solution. On the day of the op, I was told I'd be having the stapling. Back home, I followed post-operative instructions - taking the painkiller co-codamol, laxatives, and warm baths to help ease the pain. The pain lasted a week. More concerning was the urgency I experienced, which meant being within easy reach of a loo. But after three weeks it had all settled down. Now, three months later, the outcome is fantastic and the piles have gone. We're all so embarrassed to speak about these things,  but I just wish I'd had them treated sooner. Stapled haemorrhoidectomy accounts for 20 per cent of all piles surgery . Professor Angus Watson is a consultant colorectal surgeon at NHS Highland and chief investigator of a trial comparing piles treatments, led by the University of Aberdeen. Haemorrhoids occur when the anal cushions - pads of soft tissue, filled with blood vessels, that form part of the watertight seal around the back passage - become enlarged. Common symptoms are pain, bleeding, itching and prolapse - when the piles start to descend through the anal canal. Causes include chronic straining, constipation and pregnancy. Piles can also run in families. They can go away of their own accord. If not, a GP would generally recommend avoiding straining, taking mild laxatives, and eating plenty of fruit and fibre to loosen stools. Creams or suppositories can give some relief. Many contain a steroid which can take away the itch but won't cure the problem. The most common treatment is rubber-band ligation, where bands are placed around the haemorrhoids to interfere with the blood supply and shrink them. A third of patients will get a good result with this. Other treatments are surgical, usually for piles which protrude all the time. In one procedure, excisional haemorrhoidectomy, we remove the piles using a cautery device - a surgical instrument through which an electric current is passed, cutting off the haemorrhoids and sealing the tissue with heat. Stapled haemorrhoidectomy accounts for 20 per cent of all piles surgery. Here, we use a special stapling instrument, around 18in long and 1in wide, to remove a section of the lining of the lower rectum. This allows the protruding haemorrhoids to be pulled back inside the anal canal, and cuts the blood vessels that supply the piles. Then we fire in staples to seal the area. These will either stay in the patient or get passed out during bowel movements. As piles operations are common - 29,000 a year - surgeons need to know the best option for controlling symptoms long-term. So the National Institute of Health Research has given us £1.3 million to carry out a definitive trial across 32 centres. Called eTHoS, it's a comparison of stapled versus excisional surgery. Lis was randomly selected to have the stapling. First the patient is examined under general anaesthetic to check the size of the piles, which can be up to 3cm long. Through a hollow tube, we weave a purse string stitch (which you can pull tight, like a drawstring) into the lining of the rectum just above the piles. We insert the stapler into the rectum and draw the stitch tight, so that it pulls a ring of tissue, about 1cm wide, into the stapler - this has the effect of hoisting the haemorrhoids back into the anal canal. A knife inside the stapler then cuts off the trapped tissue. At the same time, it fires two or three rings of titanium staples to seal off the area. Then we apply local anaesthetic. It takes 20 to 30 minutes - the same as traditional excision. The risks for both methods are the same: pain, post-operative bleeding, and men may have difficulty emptying their bladder, so may need a catheter overnight. Some patients also describe urgency (the body can mistake healing tissue for faecal matter) but that soon settles. At this stage I don't know which technique is better. This trial will help us find out. To find out about taking part in the trial, talk to your GP. Visit w3.abdn.ac.uk/hsru/ethos .
57, a paediatric secretary and mother-of-four from Inverness, took part in a study to determine the best way of treating this common problem, as