Piles, or haemorrhoids, are normal blood vessels in the anal canal that can become swollen or inflamed, causing bleeding, pain, or prolapse. They can be classified as internal, prolapsed, or external. Internal ones form inside the rectum and may cause bleeding during bowel movements but are usually painless unless they prolapse or develop a clot. When they protrude through the anus, they are known as prolapsed haemorrhoids, which can lead to pain, bleeding, and discomfort. External types develop under the skin around the anus and may cause itching, swelling, or pain if a blood clot forms.
Haemorrhoids become more common after the age of 30, and several factors can further increase the risk of developing them. Pregnancy, for instance, raises the risk due to greater pressure on the anal region and straining during bowel movements. Other contributing factors include a sedentary lifestyle, prolonged sitting on the toilet, constipation, diarrhoea, and poor bowel habits such as reading while defecating.
Statistics from HealthXchange by Singhealth revealed one in three people in Singapore suffers from haemorrhoids. Typical symptoms include rectal bleeding, anal pain or discomfort, swelling, and sometimes the presence of anal skin tags or fissures. As these symptoms may resemble other colorectal conditions, a professional evaluation is recommended for an accurate diagnosis and proper treatment.
Diagnosis and Evaluation
While mild haemorrhoids can sometimes improve with lifestyle changes, it’s important to consult a doctor if symptoms persist beyond a few days, or if there is recurrent bleeding, pain, or swelling. Persistent bleeding could also signal other colorectal conditions that require medical assessment.
At Kam Colorectal Centre, your doctor will conduct a thorough evaluation to determine the underlying condition and recommend the most appropriate treatment plan. Your assessment may include a physical examination. In some cases, procedures such as colonoscopy will be used to rule out other conditions like polyps or colorectal cancer. These investigations help determine the severity and type of haemorrhoids, guiding the choice of treatment.
The cost of haemorrhoid treatment varies depending on the method used, the need for hospitalisation, and whether disposable equipment (such as a stapling device) is required. Your doctor will advise on the most suitable treatment option after an evaluation. For Singapore citizens, piles surgery can be reimbursed by MediSave, subjected to the amount claimable imposed by the CPF Board.
Treatment Options for Haemorrhoids
Treatment for haemorrhoids depends on their severity and symptoms. Mild cases often improve with dietary changes, adequate hydration, and topical or oral medication. If symptoms persist or become more pronounced, your specialist may recommend a minor procedure or surgery to provide lasting relief.
Conventional Haemorrhoidectomy: This is the traditional surgical approach for more severe cases. The haemorrhoids are removed using a device that cuts and seals blood vessels at the same time. It is performed under anaesthesia, usually as a day surgery, with full healing expected between four and six weeks.
Stapled Haemorrhoidectomy: An advanced procedure where haemorrhoidal tissue is repositioned and removed with a circular stapling device. This technique reduces blood flow to the area and causes less post-operative pain than traditional surgery. Most patients recover within two weeks.
Transanal Haemorrhoidal De-arterialization (THD): A minimally invasive option that uses Doppler ultrasound to identify and tie off the arteries feeding the haemorrhoids. Since no tissue is cut, discomfort is minimal and recovery is quick. THD is suitable for patients whose primary symptom is bleeding rather than prolapse.
Rubber Band Ligation: A simple clinic-based procedure performed without anaesthesia. A small rubber band is placed at the base of the haemorrhoid to cut off blood flow, causing it to dry up and fall off naturally within a few days. Mild bleeding may occur when the tissue sheds, but most patients resume their usual activities the next day.
Post-Procedure Care and Recovery
Most patients recover quickly after haemorrhoid treatment, especially with minimally invasive procedures. It’s common to experience mild discomfort, swelling, or light bleeding for a few days. Pain can usually be managed with prescribed medication, and patients are encouraged to keep the area clean and avoid straining during bowel movements. A high-fibre diet, adequate hydration, and regular exercise help prevent constipation and reduce the risk of recurrence. If you experience persistent pain, heavy bleeding, or fever, you should contact your doctor promptly for review.
Kam Colorectal Centre is committed to providing personalised care from diagnosis to recovery for haemorrhoids. Each treatment plan is tailored to ensure optimal comfort, safety, and long-term results. Explore our full suite of services or get in touch to schedule a consultation with Dr Kam Ming Hian.
