Haemorrhoids (Piles)

What are the symptoms of haemorrhoids?

Symptoms depend on the type of haemorrhoids (piles).

External haemorrhoids – Symptoms include:

• Itch
• Irritation
• Pain in the anus and surrounding area
• Swelling
• Bleeding

Internal haemorrhoids – Internal piles usually cannot be seen and rarely cause discomfort. However, straining or irritation during bowel movement can cause:

• Bleeding
• Prolapsed or protruding haemorrhoid, which may cause pain

Thrombosed haemorrhoids – This is due to a clot or thrombus forming in the haemorrhoid. You will feel a hard lump near the anus which is swollen, inflamed and painful.

Other symptoms of haemorrhoids include:

• Blood in your stools
• Itching at the anus
• Lump at the anus

Note: Symptoms of piles may resemble those of colorectal cancer. Consult your doctor for a full assessment and accurate diagnosis.

What causes haemorrhoids?

Haemorrhoids are associated with increased pressure or straining. Causes include:

• Straining during bowel movement
• Chronic constipation or diarrhoea
• Obesity
• Constant heavy lifting
• Long hours standing
• Sitting for a long period of time, especially on the toilet
• Family history of haemorrhoids
• Pregnancy

What are the risk factors for haemorrhoids?

In Singapore, 1 in 3 people suffer from haemorrhoids. It is especially common in people above 40 years old and during pregnancy.

Risk factors that contribute to the development of haemorrhoids include:

• Obesity
• Family history
• Sedentary lifestyle
• Low-fibre diet or an excessively high-fibre diet
• Poor toilet habits such as overstraining or sitting on the toilet bowl for long periods of time, which places increasing pressure on the haemorrhoids

What are the complications and related diseases of haemorrhoids?

Complications from haemorrhoids are uncommon, but may include:

• Anaemia. This is due to blood loss from chronic haemorrhoids.
• Blood clot. This is also known as a thrombosed haemorrhoid. Surgery may be required in some cases.

How do you prevent haemorrhoids?

To prevent or reduce your risk of getting haemorrhoids (piles):

• Do not delay bowel movement. Your stools may dry up and harden. This may lead to straining and increase your risk of developing haemorrhoids. It can also turn painless internal haemorrhoids into painful external haemorrhoids.
• Avoid spending long periods on the toilet. Prolonged sitting on the toilet places additional stress on the blood vessels in the anus.
• Consume more fibre. This helps to prevent constipation and straining. Alternatively, consider taking fibre supplements.
• Drink more water. This helps to avoid dehydration, which contributes to dry, hard stools and constipation.
• Exercise regularly. This prevent digestive problems by encouraging the movement of food and waste through your digestive tract. However, avoid sports or activities that involve heavy lifting.

Haemorrhoids can recur after you have recovered. Therefore, adopt healthy lifestyle habits to avoid future episodes of piles.

How are haemorrhoids diagnosed?

Your doctor can diagnose haemorrhoids through:

• Visual examination of your anus
• Digital examination, where your doctor checks your rectum for unusual growths
• Additional tests which use a small camera to detect any abnormalities in your anus, rectum or colon

How are haemorrhoids treated?

The treatment of haemorrhoids or piles depends on the type and severity of your condition. Make an appointment with our specialists for an accurate diagnosis and start your treatment early.

Your doctor may recommend the following treatments:

Lifestyle changes

These are simple preventative measures to allow regular bowel motions without straining. Examples include increasing your fibre intake and drinking plenty of water.

Home remedies

These are measures to provide relief from itch or pain. They include the use of:

• Hydrocortisone
• Haemorrhoid cream, tablets or suppositories
• Over-the-counter pain medication
• Warm baths or cold compresses

Medication

Your doctor may prescribe oral medications to treat haemorrhoids.

Rubber band ligation

A band will be placed around the haemorrhoid, which will cut off the blood circulation to part of the haemorrhoid. This treatment should only be performed by a medical practitioner.

Injection therapy

Your doctor will inject a chemical directly into the blood vessel to reduce its size. This is also known as sclerotherapy.

Surgery

Your doctor may recommend surgery to remove the haemorrhoids. Known as haemorrhoidectomy, this surgery is performed under local, spinal or general anaesthesia.