About Your Health
To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.
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Do you suffer from Haemorrhoids and Piles?
Can you relate to any of the following?
You have an underlying medical condition
Do you have a history of using Perinal to treat haemorrhoids or piles?
If so, how successful was it?
Did you know that?
If your condition does not improve after four weeks, you should consult a doctor.
Can you relate to any of the following statements?
You have or have had stomach or duodenal ulcers, as well as stomach or intestinal bleeding in the past.
Do you have a history of using Proctosedyl to treat haemorrhoids or piles?
If so, how successful was it?
Did you know that:
A healthcare practitioner should assess any acute injuries.
Can we share this information with your General practitioner?
Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advise you share this treatment with your doctor for him/her to update your medical records.
Do you have a history of using Scheriproct to treat haemorrhoids or piles?
If so, how successful was it?
Do you have a history of using Uniroid to treat haemorrhoids or piles?
If so, how successful was it?
Are you currently receiving any treatment or under any medication?
Please provide more information of the medication being used if any.
If female or transmale, are you currently pregnant, breastfeeding or planning to do so?
Please select your option
What is your biological gender?
Please select your option
Date of Birth
Use the calendar to select your date of birth.
Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924
Please explain why you require this treatment if you are not already suffering from piles.
Has a certified medical practitioner ever examined you with haemorrhoids and piles?
If do, when was the last time you saw your doctor to discuss your condition?
Have your symptoms remained the same since your previous examination?
Kindly identify some of the symptoms you may be experiencing
You can select more than one option
Did you know that that persons over the age of 55 should get their bowels screened by the NHS?
More information can be found on the link below:
Did you know that Constipation is a common cause of piles?
Constipation can cause piles, so avoid it. You may learn more about constipation treatment and prevention at https://www.nhs.uk/conditions/constipation/.
Are you experiencing any of the following signs and symptoms:
Over 40 years old and experiencing symptoms for the first time
Are you willing to visit your doctor if:
Your symptoms are becoming more severe.
Kindly provide more details of the change in symptoms
Do you have a history of using Xyloproct to treat haemorrhoids or piles?
If so, how successful was it?
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