May present as painful lumps around the anus or the passage of fresh blood during bowel movements.
May present as painful lumps around the anus or the passage of fresh blood during bowel movements.
Senior Consultant General Surgeon
MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery)
Haemorrhoids is not a condition to be ignored as it has been known to result in severe anaemia from persistent rectal bleeding.
If you suspect that you are suffering from haemorrhoids, it is important for you to read on and understand the symptoms, the severity and possible treatment plans.
In case of any emergencies, you should not hesitate to visit your nearest doctor or call us to arrange for a consultation.
Haemorrhoids are generally classified as internal or external:
External haemorrhoids are most often felt as bulges or lumps at the anus and tend to be persistently present without much discomfort. When thrombosis occurs or blood clots form within them (‘perianal hematoma’), the pain can be very acute and severe:
The haemorrhoid becomes a dark, hard lump and extremely sensitive to touch. When this happens, patients often report emergently to the doctor with intolerable pain on sitting and walking.
Internal haemorrhoids, conversely, are hidden within the anus especially when the size remains small.
Patients tend to experience painless bleeding during bowel movement as the only symptom. When internal haemorrhoids enlarge, they typically get pushed out during bowel movement resulting in discomfort.
Patients will often find themselves attempting to push them back in when cleaning themselves. When the piles enlarge further and are unable to be pushed back in, they may become prolapsed and swollen.
This again results in intolerable pain and swelling that requires immediate attention by the doctor.
If you experience these persistent symptoms, we advise that you consult a Doctor.
Haemorrhoids can be treated with timely medical intervention.
Depending on the size and symptom, treatment can start with oral medications to shrink the piles and improve blood flow, reduce constipation and the effort of defaecation.
Further treatment may be required for larger piles, particularly when they prolapse.
Typically, the Doctor will recommend rubber band ligation which can be performed in the outpatient setting. A rubber band is deployed tightly around the base of the haemorrhoid to strangulate the blood supply.
As the haemorrhoid detaches, it leaves behind a small wound that heals with scarring. Rubber band ligation is usually performed after a colonoscopy examination.
Beyond medication and rubber band ligation, surgery offers a more definitive treatment option.
The most common procedure is conventional haemorrhoidectomy, where the piles are surgically removed using diathermy or advanced bipolar device (less pain).
Another technique is stapled hemorrhoidectomy which acts like a ‘nip and tuck’ procedure. The haemorrhoids are removed through the firing of a stapling device which simultaneously draws excess mucosa upwards to counteract the prolapse.
Both surgical procedures are performed under general anaesthesia and patients will require a period of pain killers and special care instructions after surgery. Discuss with your surgeon the various treatment options including the benefits and risks of surgery.
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MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery), FSSO(USA)
Dr. Thomas Ho is a distinguished surgeon well known for his expertise in Cancer Surgery, especially in the field of Head and Neck cancers as well as Abdominal and Digestive cancers. In 2009 he was awarded a MOH scholarship and completed a Surgical Oncology Fellowship in Canada, becoming one of only a handful of surgeons in Singapore with this recognition.
Prior to private practice, Dr. Ho founded the Head and Neck Surgery and Surgical Oncology service at Tan Tock Seng Hospital. Dr. Ho is experienced in laparoscopic (keyhole) and robotic-assisted surgery, which he routinely employs in the treatment of thyroid cancer, colorectal cancer, hernias, gallbladder diseases, adrenal and spleen disorders.
The benefit of detecting surgical conditions early is to enable less invasive and extensive surgery while achieving the best results.
We are on the panel of most private insurance providers and are also accredited to process your Medisave claims.