Please click here to view the full Haemorrhoidectomy Commissioning Statement.

Background 

Haemorrhoids are enlarged vascular cushions in the anal canal and may be external or internal. They are the commonest cause of rectal bleeding

Definition of degrees of haemorrhoids:

• First grade: the haemorrhoids remain inside at all times
• Second grade: the haemorrhoids extend out of the rectum during a bowel movement but return on their own
• Third grade: the haemorrhoids extend out during a bowel movement but can be pushed back inside
• Fourth grade: the haemorrhoid is always outside

Commissioning Position

Haemorrhoidectomy will be commissioned in the following circumstances:

• Grade I or II haemorrhoids with severe symptoms which include bleeding, faecal soiling, itching or pain which have failed to respond to conservative management for 6 months.
• Grade III or IV haemorrhoids (i.e. prolapsed)

All other circumstances require prior approval.

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