The last day of operation for Hertfordshire and West Essex ICB was 31 March 2026. The information on this website has not been updated since 31 March 2026. The legacy policies, prescribing recommendations and pathways can be accessed on this website. Find out more

RAG rating
n/a
Document type
Clinical pathways
Place
Hertfordshire and West Essex ICB
Output type
Clinical Pathways
Pathway
Management of Haemorrhoids

Haemorrhoids

First degree
bleed but do not prolapse

 Consider referral to secondary care if:

  • Conservative treatment has failed AND
  • Haemorrhoids are recurrent OR
  • Are causing persistent bleeding OR
  • Cannot be reduced

Second degree
prolapse but reduce spontaneously

Third degree
prolapse but reduce manually

Fourth degree
permanently prolapsed and irreducible

 Consider referral to secondary care

Haemorrhoidectomy will only be commissioned if the above criteria are met. 

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