Take 5: Don’t lance external piles

1 minute read


Many years ago, Dr John Lumley would lance external piles thinking he’d “done a wonderful job”. How times have changed


Many years ago, Dr John Lumley, would give patients with external piles a bit of local anaesthetic and slice out a clot thinking he’d “done a wonderful job”.

These days, the Brisbane-based colorectal surgeon wouldn’t consider lancing external piles.

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“If you lance them, they tend to be sore for two weeks,” he says. But patients also experience pain for two weeks with proctosol cream, salt water waths, simple analgesia and dietary advice. “So it makes no difference,” he says.

“Give the patient advice with regards to appropriate fibre, water intake and tell them they will be sore for two weeks and the lump will go away by itself,” he says.
[media_embed]https://player.vimeo.com/video/203407800[/media_embed]

In this video, Dr Lumley discusses:

How common are symptomatic haemorrhoids?
How often are internal haemorrhoids the cause of rectal bleeding?
What investigations should be performed?
When should GPs lance thrombosed extermal piles?

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