The History of Haemorrhoid Treatment: From Ancient Remedies to Modern Procedures
A Problem as Old as Civilisation
Haemorrhoids are one of the oldest documented human ailments. The earliest surviving medical reference dates to around 1500 BC, when the Egyptian Ebers Papyrus recorded a remedy for a painful, protruding mass at the anus. Thousands of years later we are still treating the same condition, but the methods have travelled an extraordinary distance, from herbal ointments and red-hot irons to injections, rubber bands, surgery and, most recently, non-surgical electrotherapy that needs no cutting and no general anaesthetic. Looking at how piles treatment evolved is not just a curiosity. It explains why so many options exist today, why some old ideas survive in modern form, and why current treatment is gentler and safer than at any point in history.
Ancient Egypt and the First Written Remedies
Egyptian physicians treated haemorrhoids with topical preparations made from herbs, honey and natural astringents applied directly to the anus, the distant ancestors of the soothing creams and ointments people still reach for today. The aim was the same as a modern piles cream or haemorrhoids cream: to calm inflammation, ease pain and reduce swelling. Some scholars believe Egyptian healers also attempted minor surgical removal of protruding piles, which would make them among the first to operate on the condition. Whether or not that is accurate, the written record makes one thing clear, the instinct to soothe the symptom locally is as old as medicine itself.
Hippocrates and the Greek Origin of the Name
The word haemorrhoid comes from the Greek haimorrhois, meaning a flow of blood, a name that has stuck for more than two thousand years. The Hippocratic writings of around 400 BC contain a dedicated treatise on the condition and describe techniques that are recognisably surgical. One method involved tying off the haemorrhoid with thread to cut off its blood supply, a principle that survives directly in today's rubber band ligation. Another used cautery, burning the tissue with a heated instrument. The Greek texts even advised leaving one small haemorrhoid untreated to avoid complications, an early hint at the careful, conservative judgement that still guides good treatment.
Eastern Medicine and Early Classification
While Greek medicine developed in the west, physicians in ancient India were independently building a sophisticated understanding of the condition. The Sushruta Samhita, an Indian surgical text from several centuries BC, classified haemorrhoids by their appearance and described treatment with caustic pastes (kshara) and ligation, alongside dietary advice. This emphasis on diet and bowel habit was ahead of its time and remains the foundation of prevention today: fibre, fluids and avoiding straining. Understanding the different haemorrhoid types, internal, external and prolapsed, is something these early classifiers were already attempting, long before the anatomy was properly understood.
The Middle Ages: Saints, Superstition and the Hot Iron
For much of the medieval period, treatment was a mixture of religion, folklore and crude surgery. Haemorrhoids were sometimes called 'Saint Fiacre's curse', after a seventh-century monk who, according to legend, was cured of them and became the patron saint of sufferers. Pilgrims travelled to his shrine seeking relief. Practical treatment, when it happened, often meant cautery with a hot iron, performed by monks, barber-surgeons or travelling practitioners. In the fourteenth century the English surgeon John of Arderne wrote influential descriptions of anal conditions and their management, helping to drag treatment slowly back towards observation and technique rather than ritual.
The Nineteenth Century and the Birth of Modern Surgery
The 1800s transformed haemorrhoid treatment, driven by anaesthesia, antisepsis and a better grasp of anatomy. In the late 1860s, injection sclerotherapy appeared: a chemical solution injected into the haemorrhoid to shrink it and seal its blood supply, a genuinely minimally invasive idea that is still used in modified form today. Surgical removal also became more systematic. In 1882 Walter Whitehead described a circular excision technique that bore his name, though it later fell out of favour because of its complications. The century established the two great strands of treatment that persist now: destroy or shrink the haemorrhoid without major surgery, or cut it out cleanly when necessary.
The Twentieth Century: Standardised Haemorrhoidectomy
Surgical removal of haemorrhoids, the haemorrhoidectomy, was refined into reliable, teachable operations in the twentieth century. In 1937, surgeons at St Mark’s Hospital in London described the open haemorrhoidectomy that became known as the Milligan-Morgan technique, still one of the most widely performed haemorrhoid operations in the world. In 1959 an American closed variant, the Ferguson haemorrhoidectomy, offered an alternative in which the wounds were stitched. These operations are effective and remain the standard for severe, large or recurrent haemorrhoids, but they involve real pain and a recovery measured in weeks, which is exactly the drawback that later, gentler methods set out to solve.
Rubber Band Ligation: An Ancient Idea Reborn
The mid-twentieth century revived the oldest principle of all, cutting off a haemorrhoid’s blood supply, in a far more practical form. In 1958 a small rubber band was first used to ligate an internal haemorrhoid, and in 1963 the technique was refined into the rubber band ligation still performed today. A tight band is placed at the base of an internal haemorrhoid; deprived of blood, it shrivels and drops off within days. It is quick, needs no anaesthetic and can be done in a clinic, which made it enormously popular. It does not suit every haemorrhoid, and it can cause discomfort and occasional bleeding, but it proved that effective treatment did not have to mean major surgery.
Heat, Light and Cold: The Office-Based Era
From the 1970s onwards a family of office-based techniques aimed to treat haemorrhoids with energy rather than the knife. Infrared coagulation applies controlled heat to the base of the haemorrhoid, scarring and sealing its blood supply. Improved chemical formulations kept injection sclerotherapy in regular use for smaller internal piles. Cryotherapy, which froze the tissue, was tried but largely abandoned because of pain and unpredictable healing. Together these methods reinforced a clear direction of travel: treat the problem in a short outpatient visit, avoid hospital admission, and let people return to normal life quickly. They set the stage for the minimally invasive revolution that followed.
The Minimally Invasive Revolution
The turn of the millennium brought a wave of techniques designed to match the results of surgery with far less pain. In 1998 stapled haemorrhoidopexy was introduced, using a circular stapler to lift and reposition prolapsed tissue rather than excising it. Doppler-guided haemorrhoidal artery ligation (also known as HALO or THD) used ultrasound to find and tie off the precise arteries feeding the haemorrhoids. Laser haemorrhoidoplasty and radiofrequency methods such as the Rafaelo procedure shrink the haemorrhoid with precisely targeted energy through a tiny probe. Each of these reflects the same ambition that has driven the whole history: keep the effectiveness, lose the trauma.
The Latest Generation: Non-Surgical Electrotherapy
The most recent step is treatment that needs no cutting, no stitching and no general anaesthetic at all. Non-surgical electrotherapy, the eXroid procedure used at Haemorrhoid Centre, applies a precise low-level electrical current directly to an internal haemorrhoid during a proctoscopy. The current disrupts the blood supply so the haemorrhoid shrinks over the following weeks, and several haemorrhoids can be treated in a single short appointment. Most patients walk out and return to their normal day immediately. In a sense it completes a four-thousand-year arc: it shares the ancient goal of cutting off the haemorrhoid’s blood supply, but achieves it with a control and gentleness the early healers could never have imagined. You can read exactly how it works on our procedure page.
What the History Tells Us About Treatment Today
The long story of piles treatment carries a practical lesson. Soothing creams and good bowel habits, the oldest interventions of all, still matter and are still the right first step for mild symptoms. But where they are not enough, there is no longer any need to jump straight to painful surgery. The modern range, from banding to electrotherapy, means treatment can be matched to the individual haemorrhoid and the individual patient. The single most important constant across four millennia is also the simplest: get a proper assessment. The right treatment depends entirely on the type and severity of your haemorrhoids, which is something only an examination can establish.
Modern Treatment at Haemorrhoid Centre
If you would like to benefit from the latest stage of this long history, our specialists offer non-surgical electrotherapy alongside a full assessment by a consultant colorectal surgeon. We diagnose the problem properly, explain the options in plain language, and where appropriate treat internal haemorrhoids in the same visit, with no anaesthetic and minimal downtime. To learn more about the procedure, or to discuss whether it is right for you, contact us to arrange an appointment.
Related Articles
To understand the conditions described here in more detail, read our guides on the different haemorrhoid types and on sentinel piles and anal skin tags. For more on symptoms and self-care, see our articles on anal pressure and haemorrhoid smells, and our overview of modern haemorrhoid treatments. If you are weighing up your options, our piles treatment guide and general haemorrhoid advice explain what to expect.
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Haemorrhoid centre Glasgow
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