Rafaelo Procedure (Radiofrequency Treatment of Haemorrhoids under Local Anaesthesia)
The Rafaelo procedure is a modern, minimally invasive treatment for haemorrhoids that uses radiofrequency energy to reduce or remove swollen tissue. It’s performed under local anaesthetic and provides a quick and comfortable alternative to traditional surgery with reduced recovery times.
What is the Rafaelo procedure?
The Rafaelo procedure (short for Radio Frequency Ablation of Haemorrhoids under Local Anaesthesia) is a new and highly effective way to treat internal haemorrhoids. Haemorrhoids, often called piles, are swollen veins in or around the back passage (rectum). They can cause symptoms such as itching, bleeding, discomfort, and prolapse (bulging out of the anus).
If creams, suppositories, or dietary changes haven’t helped, the Rafaelo procedure provides a minimally invasive option that avoids the pain and downtime of conventional haemorrhoid surgery.
The Rafaelo procedure works by gently heating the internal part of the haemorrhoid using radiofrequency energy. These internal tissues don’t contain pain-sensitive nerve endings, so the treatment itself isn’t painful. The heat causes the blood vessels inside the haemorrhoid to shrink and seal, which makes the tissue gradually shrivel and disappear over time.
The external part of a haemorrhoid, which is covered by normal skin and contains pain receptors, can’t be treated directly with radiofrequency energy. However, once the internal part has been reduced, it naturally lifts and pulls the external area back inside the anal canal. This makes the haemorrhoid much smaller and less likely to cause discomfort, itching, or swelling.
At Welbeck, our colorectal specialists are experts in advanced haemorrhoid treatments and perform the Rafaelo procedure regularly, with outstanding outcomes. You’ll receive your care in our Surgery Centre, where our consultants have access to state-of-the-art surgical facilities and the latest minimally invasive technology to ensure your treatment is as comfortable as possible, with a quick, smooth recovery.
As part of your care, we also provide clear aftercare advice to help you maintain long-term bowel health — including guidance on diet, hydration, and lifestyle changes to reduce the chance of haemorrhoids returning and to support lasting symptom relief.
In this video, our Digestive Health team explains the Rafaelo procedure in more detail.
More information
When you arrive at the clinic, your consultant will carry out a full assessment, including a discussion of your symptoms and a gentle examination. This usually involves a proctoscopy, where a small, narrow telescope is inserted into the back passage to assess the size and position of your haemorrhoids and rule out any other conditions. Based on this assessment, your consultant will confirm whether the Rafaelo procedure is suitable for you. If it is, treatment can usually take place during the same visit; if not, you’ll be advised on the most appropriate alternative options.
The Rafaelo procedure is usually performed using a local anaesthetic, although Entonox (also known as gas and air) and light sedation can also be used, if preferred.
During the procedure:
You’ll lie comfortably on your side, and your consultant will apply a local anaesthetic around the treatment area.
A small, fine probe is inserted a few millimetres into the haemorrhoid tissue.
Your consultant will deliver controlled radiofrequency energy through the probe to heat and shrink the tissue.
The probe is removed, and no stitches or cuts are required.
The procedure usually takes less than 30 minutes, and most people describe only a mild feeling of warmth or gentle pressure during treatment. If you do feel any discomfort, this simply means the tissue is heating a little more than expected. Let your consultant know straight away — they will pause the treatment and cool the area with a saline solution before continuing safely. This ensures the procedure remains comfortable throughout.
You’ll be able to go home shortly after your procedure and can drive yourself if you’ve only had a local anaesthetic.
The Rafaelo procedure is considered to be very safe and well-tolerated. However, as with any medical treatment, there are some risks.
Risks of the Rafaelo procedure include:
mild discomfort, burning, or swelling around the treated area (usually short-lived)
light bleeding for up to a week (less than an eggcup full a day)
temporary mucus discharge
small risk of infection
rare recurrence of haemorrhoids, especially if constipation returns
Rarely, people can develop an anal fissure (a superficial tear in the skin lining the anal canal) after procedures for haemorrhoids, although this has not been officially reported after the Rafaelo procedure so far. Signs of an anal fissure are severe pain in the anus on opening your bowels and sometimes a small amount of bright red bleeding. If you experience either of these symptoms, get in touch.
Your consultant will give you clear instructions on how to prepare for the day, which usually include:
continuing to eat and drink normally
avoiding constipation by keeping hydrated and maintaining a high-fibre diet
arranging for someone to accompany you home if you’re having sedation
No special bowel preparation is usually required, but your consultant will advise if this is needed for your specific case.
You’ll be able to go home shortly after treatment and can resume light activities on the same day. You may notice some mild swelling, tenderness, or a feeling of fullness in the back passage for a few days after the procedure. This is a normal part of the healing process as the treated tissue settles. You can take paracetamol or ibuprofen for comfort if needed, but avoid aspirin unless your consultant advises otherwise, as it can increase bleeding.
It’s normal to have a small amount of bleeding or spotting (less than an eggcupful a day) for up to 2 weeks after the procedure. In about 4 in 100 people, heavier bleeding can occur — either within the first 48 hours or around 10 to 14 days later, when a small clot naturally comes away from the treatment site.
If you notice heavy bleeding (more than 200 mL within 24 hours), get in touch immediately, or go to your nearest A&E department. Most bleeding settles quickly and doesn’t cause any long-term problems, but it’s always safest to get checked if you’re unsure.
It’s also common to feel an urge to open your bowels for up to 48 hours after the procedure. This happens because the nerves in the back passage are temporarily stimulated by the radiofrequency energy used during treatment. You may feel as though you urgently need to go to the toilet, but often nothing comes out — this is completely normal and simply means that your bowel is empty even though the nerves are still sending signals. The sensation usually settles down within the first 2 days. Try not to strain or worry — the feeling will pass on its own.
To support healing and prevent recurrence, your consultant may recommend:
drinking plenty of fluids and eating a fibre-rich diet
avoiding heavy lifting or strenuous activity for 48 hours
using gentle wet wipes instead of dry toilet paper for a few days
continuing any prescribed stool softeners to avoid straining
Most patients notice symptom improvement within 2 to 4 weeks, and the results are typically long-lasting. We’ll arrange a follow-up appointment after 4 weeks to check your recovery and ensure your symptoms have resolved.
At Welbeck, we offer 2 pricing options for the Rafaelo procedure, depending on the type of anaesthetic you have:
with local anaesthetic – from £2,285
with sedation – from £2,595
Your consultant will discuss which option is best for you based on your comfort and medical needs.
At Welbeck, our colorectal surgeons are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
To book the Rafaelo procedure, you must be referred by either your GP or a colorectal specialist following a consultation with them. Self-referrals are not accepted for this treatment.
If you’d like to schedule a consultation with a colorectal specialist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
Our locations
Loading
Frequently asked questions
Most patients begin to notice improvement within a few days, but it can take up to 6 weeks for the haemorrhoids to shrink fully and for all symptoms to resolve. This timeline depends on the size of the haemorrhoids and your bowel habits during recovery. Maintaining a healthy diet with plenty of fibre will help speed up healing. We’ll follow up with you after around 4 weeks to check on your recovery.
Recurrence is rare but possible, especially if you become constipated or strain during bowel movements. To reduce this risk, your consultant will provide advice on diet, hydration, and exercise. If haemorrhoids do return, the procedure can usually be repeated safely.
At Welbeck, our consultants use this treatment to target grades 1 to 3 internal haemorrhoids — the types that cause discomfort, bleeding, or prolapse, but are not large external piles. We find that, in practice, 9 out of 10 people are satisfied with the outcome of the procedure. 1 in 10 feel that their symptoms have not improved sufficiently afterwards. In these cases, the Rafaelo procedure can be repeated, or an alternative treatment may be required. Your consultant will advise you on this when you attend for a follow-up consultation.
Haemorrhoids can be treated with several alternative treatments, including rubber band ligation, or a procedure where stitches are placed in the blood vessels that supply the haemorrhoid under ultrasound guidance. Ultimately, the haemorrhoid can also be completely removed by surgery.