The Counsel is a private coaching practice for founders and leaders, offered one to one or within a small cohort. The work is candid, structured, and held in confidence.

Who is the coaching for?

For leaders who lead something real — a founder, an executive, or a partner — who have outgrown advice, are ready to do the work, and value discretion.

How does the coaching work?

Engagements run in seasons rather than single calls: regular one-to-one sessions of around ninety minutes on a steady cadence, access between them, and a structured review each quarter. There is also a small twelve-week cohort, held twice a year.

The work begins with a conversation. Most clients come by referral, but a direct enquiry is welcome and is read personally, not by a form. You can request a conversation from the enquire page.

Is the coaching in person or online?

Both. Sessions are held in person and online for those further afield.

How much does it cost?

Fees are shared in the first conversation, matched to the shape of the engagement.

Hemorrhoid Treatment

Explore hemorrhoid treatment in Thailand, including minimally invasive procedures, surgical removal, laser treatment and personalised colorectal care.

TYPICAL COST

Approx. US$3,000–4,000+

TYPICAL STAY

Day procedure to around 1 night in hospital

RECOVERY

Discomfort and swelling are common initially, with light daily activities usually resuming gradually over the following days.

Hemorrhoid Treatment in Thailand

Hemorrhoid treatment may be considered when symptoms such as bleeding, pain, itching or prolapse persist despite lifestyle changes or medication.

Thailand offers specialist colorectal surgeons and a range of treatment options, from outpatient procedures to surgical and laser techniques for more severe or recurring hemorrhoids.

Siam Medica can help international patients explore suitable providers and specialists, request personalised treatment plans and cost estimates, and coordinate care before, during and after treatment in Thailand.

What are hemorrhoids?

Hemorrhoids, also known as piles, are swollen veins in the lower rectum or around the anus.

They may be:

Internal hemorrhoids, which develop inside the rectum
External hemorrhoids, which develop under the skin around the anus

Symptoms can vary from mild irritation to significant discomfort, bleeding or prolapse.

When may treatment be needed?

Mild hemorrhoid symptoms can often improve with measures such as increased fibre intake, fluids, avoiding straining and short-term medication.

A procedure may be considered when:

Bleeding continues or recurs
Pain or discomfort becomes significant
Internal hemorrhoids repeatedly prolapse
Symptoms interfere with everyday life
Less invasive treatments have not worked
Large or recurring hemorrhoids are present

Rectal bleeding should be assessed properly because it can have causes other than hemorrhoids.

Minimally invasive treatment

Some internal hemorrhoids can be treated without conventional surgery.

Options may include:

Rubber band ligation

A small rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply.

The hemorrhoid then shrinks and usually separates naturally.

Sclerotherapy

A solution is injected into the hemorrhoid tissue to make it shrink.

Coagulation treatments

Infrared, heat or laser energy may be used to shrink selected internal hemorrhoids.

These treatments are generally used for smaller or less advanced hemorrhoids and may be performed without an overnight hospital stay.

Hemorrhoidectomy

A hemorrhoidectomy is a surgical procedure in which enlarged hemorrhoidal tissue is removed.

It may be recommended for large, severe or recurring hemorrhoids, particularly when less invasive treatments have not been effective.

The procedure may be performed under general, spinal or other anaesthesia depending on the individual case.

Hemorrhoidectomy is considered one of the most definitive treatments for severe or recurring hemorrhoids, although recovery can involve more discomfort than less invasive procedures.

Laser hemorrhoid treatment

Laser techniques may be used in selected patients to treat hemorrhoidal tissue.

The exact approach varies depending on the type and severity of the hemorrhoids.

Some laser procedures may involve less tissue disruption and can sometimes be performed as day surgery, but they are not necessarily the best option for every case.

A colorectal specialist should recommend the treatment based on the individual diagnosis.

Assessment and diagnosis

Before treatment, the specialist will usually review symptoms and medical history and perform an examination.

Assessment may include:

Physical examination
Digital rectal examination
Anoscopy or proctoscopy
Review of bleeding symptoms
Additional bowel investigation when appropriate

In some patients, further tests such as sigmoidoscopy or colonoscopy may be recommended to exclude other causes of bleeding or bowel symptoms.

Preparing for treatment

Preparation depends on the type of procedure planned.

The medical team will review medications, existing health conditions and any previous colorectal treatment.

Patients may require blood tests or anaesthetic assessment before surgical procedures.

The specialist may also give instructions regarding food, fluids and bowel preparation where relevant.

International patients should allow sufficient time in Thailand for assessment, treatment and early follow-up before travelling home.

Hospital stay and recovery

Less invasive hemorrhoid treatments are often performed as outpatient or day procedures.

Surgical hemorrhoidectomy may require an overnight hospital stay depending on the patient and procedure.

Pain, swelling and discomfort during bowel movements can occur during early recovery.

Patients are usually advised to maintain soft stools, drink plenty of fluids and follow dietary and medication instructions carefully.

Light daily activity can generally resume gradually, while strenuous activity may need to be avoided until the specialist confirms that healing is progressing appropriately.