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To develop a simple scoring system to assess the severity of haemorrhoidal disease and its impact on quality of life.A questionnaire (HASS) assessing five different parameters was developed. The parameters scored from 0 to 4 were bleeding at defaecation, haemorrhoidalprolapse, need for manual reduction, pain at defaecation and impact on quality of life. A total score of 0 corresponded to the complete absence of haemorrhoidal symptoms while a score of 20 would correspond to the worst possible degree of symptoms. Patients were asked to complete the HASS and the MOS-SF 36 health questionnaires. The scores from the patient's questionnaires were then compared to the treatment received to see if the score couldpredict the type of intervention required.Seventy-four patients were enrolled in the study. Patients who had conservative management had a mean HASS score of 4.82 whilst those who underwent surgical intervention had a mean HASS score of 12.08 (P < 0.0001). There were no differences in the MOS-SF-36 scores between patients treated conservatively and those who underwent surgery.While the MOS-SF-36 does not correlate to the severity of haemorrhoidal symptoms, the HASS can reliably assess it andpredict the need for surgical intervention.