Your questions, answered
by the specialist

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

A proctological examination, when carried out by an experienced specialist, is generally well tolerated. It is performed with the patient in the lateral position, progressively and with adequate lubrication. Anoscopy — which allows visualisation of the anal canal — may be slightly uncomfortable but is not painful in most cases.

If there is an active anal fissure or another painful condition in the anal region, the examination may sometimes not be possible at that appointment. In such cases, it is preferable to treat the condition first and perform it once resolved, ensuring a complete diagnosis without unnecessary discomfort.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

It depends on the type of procedure. Outpatient techniques such as rubber band ligation or foam sclerotherapy are performed without anaesthesia and are virtually painless at the time, with only mild discomfort in the hours that follow.

At the ONEstep® clinic we use minimally invasive techniques that minimise discomfort and allow rapid recovery.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

The number of sessions varies according to the grade of the haemorrhoids and the technique used. In most cases, a single treatment session is sufficient to resolve the problem. Some haemorrhoids may require a complementary second session.

Following the initial assessment I will advise on the most appropriate technique and number of sessions for your particular case.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

Pain improvement is usually noticed within the first 7–10 days following the injection, as the botulinum toxin reduces internal sphincter spasm and allows the tissue to regenerate.

Complete healing typically occurs between 6 and 12 weeks, with a healing rate of up to 70% in correctly selected chronic fissures. During this period it is essential to maintain a fibre-rich diet, adequate hydration, and the prescribed topical treatment.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

These are two distinct conditions, although both affect the anal region. An anal fissure is a small wound at the edge of the anus causing intense pain during and after defecation, with bleeding. It is usually related to constipation or excessive straining.

An anal fistula is a pathological tract connecting the anal canal to the perianal skin, usually following a previous abscess that has not healed, with intermittent discharge. Both have specific and different treatments.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

In the vast majority of cases, yes. Haemorrhoid procedures — rubber band ligation and foam sclerotherapy — can resolve more than 90% of grade I, II and III haemorrhoids without surgery. Even certain selected grade IV haemorrhoids can be successfully treated non-surgically.

Surgery is reserved for large grade IV haemorrhoids that have not responded to previous non-surgical procedures. At the ONEstep® clinic we assess each case individually and always prioritise the least invasive options when effective.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

Painless bright red bleeding is usually due to common, benign causes such as haemorrhoids, an anal fissure or a polyp. Although it is rarely serious, any rectal bleeding should be assessed in clinic to confirm the exact cause, as different conditions can present with similar symptoms.

At the first visit we can usually identify the cause and, in many cases, treat it during the same appointment. I'd recommend not leaving it and booking an assessment.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

Hello, yes — you can treat your internal haemorrhoids without going to theatre. Foam sclerotherapy is a very effective outpatient technique, especially for grade I and II haemorrhoids with bleeding as the main symptom, which sounds like your case. It involves injecting a sclerosing agent in foam form directly into the haemorrhoidal tissue, causing the vessel to shrink and stop bleeding. We do it in clinic under topical anaesthesia, it takes about 10-15 minutes, and you walk out the same day. Discomfort is minimal during and after the procedure. At our clinic in Almería we follow the ONEstep protocol: we see you, assess you and, if you're a suitable candidate, treat you in the same visit. If you'd like us to assess your specific case, call us on +34 950 264 245 or message us on WhatsApp at +34 639 518 954. Best wishes.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

Hello, from what you describe you have grade III internal haemorrhoids, which are precisely the ones best suited to rubber band ligation. It's a very effective outpatient technique that involves placing a small rubber band at the base of the haemorrhoidal cushion. The band cuts off the blood supply, the tissue becomes necrotic and falls away on its own within 5-10 days. We do it in clinic without general anaesthesia, it takes about 10 minutes, and you walk home the same day. Discomfort is minimal because the area where we place the band has no pain-sensitive nerve endings. You may notice a feeling of pressure for the first few days, but nothing comparable to surgery. At our clinic in Almería we follow the ONEstep protocol: we assess you and, if you're a suitable candidate, treat you in the same visit. It's the definitive solution so you no longer have to push your haemorrhoids back in manually. The best next step is a professional proctological assessment to confirm whether you're a candidate for this technique. Best wishes.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

Hello. From what you describe, this is most likely an anal skin tag: a soft, hanging excess of skin at the edge of the anus. Unlike haemorrhoids, which are dilated blood vessels, a skin tag is just skin, with no vascular component, so it doesn't bleed or hurt on its own in most cases. They are benign remnants, unrelated to cancer, and pose no health risk. They usually remain as a consequence of a previous thrombosed external haemorrhoid that resolved, or of a prior anal fissure. Not all of them need removing: it is only recommended when they cause real discomfort, such as difficulty with hygiene, itching, a bothersome lump or an aesthetic concern. When treatment is appropriate, removal is done on an outpatient basis in the clinic itself, under local anaesthesia and without hospital admission: the base is cut with an electric scalpel and the small wound heals within a few days. Even so, it's advisable for a proctologist to confirm the diagnosis, because only an examination can reliably tell a skin tag from a haemorrhoid. At the ONEstep clinic in Almería we assess you and, if you're a suitable candidate, treat you in the same visit. Best wishes.

Dr. Jaime Jorge Cerrudo · Specialist in Coloproctology

Hello. There are two possible reasons and it is worth telling them apart. The first, and the most frequent, is that lesions inside the anal canal were left untreated. Warts do not appear only on the skin around the anus: they also grow inside, where they cannot be seen on inspection or felt on examination. If treatment was limited to the external lesions and nobody examined the inside, those lesions are still there and reappear within a few weeks. This is why anoscopy is essential: it is a simple examination, carried out in the clinic itself, with no anaesthesia and no prior preparation, and it allows the anal canal to be seen from within. The second reason is that the papillomavirus can remain latent in completely normal-looking tissue, so new lesions may appear later even if the treatment was correct and complete. This does not mean anything was done wrong; it is how the virus behaves, and it is why follow-up appointments are part of the treatment. In both cases the important thing is not to let them grow: a few small lesions are resolved with electrofulguration in clinic, under local anaesthesia and in a single session, whereas extensive involvement may require an operating theatre, general anaesthesia and several sessions. My advice is to be reassessed, including anoscopy. At the ONEstep clinic in Almería we examine you and, where appropriate, treat you in the same visit. Best wishes.