What You Need to Know About Haemorrhoids
Dr. Kam Ming Hian
MBBS (Singapore), M.Med (Surgery)

Senior Consultant,
Colorectal Surgeon

Also called piles, haemorrhoids are the lumps that appear inside and around a person’s anal passage. This condition occurs when the haemorrhoidal blood vessels – located in the lowest part of the rectum and anus – become swollen due to excessive straining during bowel movement. Other causes of haemorrhoids are pregnancy, obesity, chronic diarrhea or constipation. Haemorrhoids are classified into two general categories. – Internal and External.

  • Internal Haemorrhoids

    This type of haemorrhoids do not usually hurt since it lies inside the rectum where there are fewer pain-sensing nerves. The most common indication of internal haemorrhoids is bleeding. There are instances when it prolapses outside the anus. When this happens, it appears as pinkish-purplish lumps at the anal opening. Prolapsed haemorrhoids may hurt but it usually recedes back into the rectum on their own. If it doesn’t, it can be gently pushed back into place.

  • External Haemorrhoids

    External haemorrhoids may cause great discomfort as they are situated outside the anus. When a person with external haemorrhoids passes stool, the piles to may prolapse outside, causing extreme pain. This condition, known as thrombosis, can be quite alarming as there is formation of blood clots and the piles turn purple or blue in color. When the pain becomes unbearable, there is an option to undergo a day surgery that will remove the thrombosed haemorrhoid.

  • Early Signs and Symptoms of Haemorrhoids

    Haemorrhoids usually display three main indications:

    1. A lump outside the anus;
    2. Bleeding; and
    3. Pain caused by thrombosis

    Note that these symptoms may also be early signs of more serious conditions like Colon Cancer. This is why it is important to consult a doctor immediately when you feel pain and discomfort from passing stools. Aside from the above-mentioned symptoms, other common signs you should watch out for are as follows:

    • Pain after bowel movement
    • Irritation or a tingling sensation around the area of the anus
    • Bleeding during defecation
    • Changes in bowel habits
    • A mucus anal discharge
  • Treatment for Haemorrhoids

    Piles can be treated through simple medications that are found at most pharmacies. Painkillers – such as paracetamol – can help in relieving pain caused by piles. Suppositories, creams, and ointments can lessen swelling and inflammation.

    Note that these treatments are only good for relieving symptoms on a short-term basis, they do not get rid of the haemorrhoids themselves. When a haemorrhoid has already becomes too painful or uncomfortable, your doctor may suggest removal through surgical procedures.

    Here at KAM Colorectal, we offer the following treatments:

    • Rubber Band Ligation
      This is a simple procedure in which the haemorrhoid is tied off to reduce the blood flow. However, this treatment is only for internal haemorrhoids. During this procedure, the doctor inserts an anosope into the anus and grasps the haemorrhoid with an instrument to help place a rubber band around its base. In about a week, the haemorrhoid shrinks and eventually falls off.
    • THD (Transanal Haemorrhoid Dearterialisation)
      Also called Haemorrhoidal Artery Ligation, THD is a minimally invasive surgical procedure that can be done for patients diagnosed with Grade 2 or 3 haemorrhoids. During THD, the arteries that supply blood to the haemorrhoid are gently sutured through the window of a specially designed proctoscope. Because THD does not cut or remove any haemorrhoidal tissue, post-operative complications are much less compared to other surgical procedures.
    • Stapled Haemorrhoidectomy
      Stapled haemorroidectomy uses a circular, hollow tube that is inserted into the anal canal. A long thread is then woven around it and above the internal haemorrhoids, pulling the tissue into the jaws of the stapler. The tissue is then removed and the two ends are joined together using staples. The procedure usually takes about 30 minutes, and is performed as a day surgery under general anaesthesia. This surgical technique is used to treat third and fourth-degree haemorrhoids and is associated with much less pain than the traditional haemorroidectomy.
    • Conventional Haemorrhoidectomy
      This surgery is performed under general anaesthesia and can be performed in the Day Surgery setting. During conventional haemorroidectomy the piles are cut off carefully to prevent excessive bleeding. The wound is usually left open to allow for easy cleansing. Unlike the other surgical procedures, the main disadvantage of conventional haemorroidectomy is the higher degree of pain experienced after the operation.

    If you have other questions or enquiries regarding haemorrhoids and their treatments, we invite you to schedule an appointment with our Colorectal Surgeon, Dr. Kam Ming Hian today. Here at Kam Colorectal, we make sure that our patients are given quality medical service at an affordable cost.