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NICE award of Medtech Innovation Briefing (MIB) to the eXroid electrotherapy treatment of haemorrhoids 6 January, 2020

The National Institute for Health and Care Excellence (NICE) produces ‘MedTech Innovation Briefings’ (MIB) as advisory notices, to inform healthcare organisations of safe and effective technology and thereby avoiding the need for organisations to produce similar information locally.

MIBs are an advanced level of NICE approval, are commissioned by NHS England and produced in support of the NHS 5-Year Forward View, specifically as one of a number of steps which will accelerate innovation in new treatments and diagnostics.

As of the 10th December 2019, we are pleased to announce that the NICE guidance in support of electrotherapy for the treatment of haemorrhoids, IPG525, has now been progressed to NICE MIB status MIB201stating eXroid electrotherapy as a safe and effective treatment for internal haemorrhoids.

The eXroid treatment has arguably the most significant patient benefit based outcome of its comparative treatment group, including: full ambulatory walk-in, walk-out convenience, cost, no anaesthesia or bowel preparation, in-treatment tolerance level, comparatively low complication rate and a rapid recovery rate (90% of patients report a return to normal duties within the same day).

The treatment itself is performed above the dentate line and works by a probe being gently placed at the base of the haemorrhoid to be treated and a low current (<16mA) then applied at a tolerable level for the patient. This results in a chemical reaction within the vascular feeding vessels, releasing hydrogen gas and hydroxyl ions (2 H2O + 2e → H2 + 2 OH-). This creates a strong alkaline environment that causes the denaturation of protein, thrombosis of the capillary feeding vessels, and a chemical cauterization within the vascular feeding vessels of the haemorrhoid. This is a chemical reaction and specifically not a heat treatment.

Consultant Surgeons who have cynically approached and tested the treatment have been amazed by the reactions of their patients and have been won over by the simplicity, effectiveness and safety of the treatment and are now backing eXroid to become a mainstream treatment.

Mr Paul Mackey, Consultant Colorectal Surgeon, said: “I have now had the opportunity to treat over 100 patients suffering with haemorrhoids with the eXroid electrotherapy treatment. Admittedly I was somewhat sceptical as to what could realistically be achieved by such a relatively straightforward and practically painless treatment, but the feedback from patients has been absolutely amazing. We are not far from eXroid becoming universally the first-line treatment for haemorrhoids, and banishing such ineffective treatments such as banding to history.”

The eXroid treatment is fully in line with the NHS Five Year Forward Plan. The 2019 commissioning guidance directs the development of services to move away from main theatre interventions to effective clinic-delivered procedures that are more accessible for patients and that allow them to return to a normal self-sustaining lifestyle without debilitating underlying conditions.

eXroid are continuing to work with NICE to produce and evaluate treatment evidence for grade 4 disease and hope to have further official guidance published to support the treatment’s efficacy for this condition in due course.