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Piles (Haemorrhoids)

Haemorrhoids, commonly known as Piles, are swollen veins in your anus and lower rectum, and they look similar to varicose veins. Even though piles can be painful and alarming, there are effective options available to treat them.

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When Should You See A Piles Specialist?

Most of the time, symptoms of small haemorrhoids tend to resolve after a few days with home care. However, if your symptoms persist for more than a week, you may have chronic haemorrhoids and should consult a specialist.

Go to the nearest A&E if you have large amounts of bleeding in your rectum, feel lightheaded, dizzy, or faint. One should also see a doctor if severe pain or swelling around the anus.

Why It's Important To Consult A Specialist When You Notice Symptoms

Symptoms of piles may be similar to other colorectal conditions, such as colorectal cancer. We strongly advise you to seek medical advice early to rule out other conditions. Additionally, serious piles that go untreated may lead to more serious complications such as infection and anal fistulas.

Accredited General Surgeon In Singapore

Dr. Sim Hsien Lin’s main sub-specialty is in colorectal surgery. In addition, her sub interests include laparoscopic colorectal surgery, transanal endoscopic microsurgery, management of piles, inflammatory bowel diseases, complex anal fistulas as well as diagnostic and therapeutic endoscopic procedures.

Dr. Sim Hsien Lin

Consultant General Surgeon (Colorectal Surgery)
  • MBBS (Singapore)
  • MRCS (Edinburgh)
  • MMed (General Surgery)
  • FRCS (Edinburgh)

Dr. Sim Hsien Lin is a specialist colorectal surgeon in Singapore with over 10 years of experience in colorectal surgery. Her sub interests include laparoscopic colorectal surgery, transanal endoscopic microsurgery (TEMS), surgical management of piles, inflammatory bowel diseases and complex anal fistulas.

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Dr. Sim Hsien Lin’s main sub-specialty is in colorectal surgery. In addition, her sub interests include laparoscopic colorectal surgery, transanal endoscopic microsurgery (TEMS), surgical management of piles, inflammatory bowel diseases, complex anal fistulas as well as diagnostic and therapeutic endoscopic procedures.
DR. SIM HSIEN LIN

Causes & Symptoms Of Piles

Symptoms Of Piles

In most cases, symptoms of piles are not serious and go away on their own after a few days. You may have piles if you’re experiencing the following:

  • hard lump or swelling around the anus
  • a feeling of fullness in your anus even after a bowel movement
  •  bright red blood on your toilet tissue or in the toilet bowl
  • feelings of soreness or itchiness around the anus area
  • painful when passing stools

What Causes Piles?

Piles generally develop when there’s increased pressure in your lower rectum and this may be due to the following:

  • chronic constipation
  • constantly straining when passing stools
  • chronic diarrhoea
  • pregnancy

The risk of developing piles increases as you age due to the weakening and stretching of the tissues that support the veins in the rectum.

During pregnancy, the weight of the baby may put pressure on the anal region, causing piles.

How Are Haemorrhoids Diagnosed?

Larger haemorrhoids are usually diagnosed by a physical examination by your colorectal specialist. However, smaller haemorrhoids that do not prolapse cannot be felt, and your specialist may use a proctoscope to see the haemorrhoids.

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    Treatment Options For Piles Based On Grade

    Grade 1

    Grade 1 piles are small swellings on the inside lining of the anal canal that cannot be seen or felt from the outside. They do not prolapse or protrude out of the anus. These are common and can be diagnosed using a proctoscope during a proctoscopy.

    Grade 1 piles are usually treated with medications or topical suppositories.

    Suppositories are a type of topical medicine meant to be inserted into the rectum, where they dissolve and are absorbed through the lining of the rectum. Your doctor may prescribe constipation medications to prevent your piles from recurring.

    Due to the small size of Grade 1 piles, no surgical intervention is necessary.

    Grade 2

    Grade 2 haemorrhoids are internal haemorrhoids that prolapse but then go back inside the anal canal spontaneously without interference.

    For Grade 2 haemorrhoids, doctors will often try conservative treatment therapies, such as painless in-office treatment procedures like rubber band ligation, injection sclerotherapy, or infrared coagulation. These treatments are performed on internal prolapsed haemorrhoids only, not external haemorrhoids. While these treatments for Grade 2 haemorrhoids usually last from six months to a year before they need to be repeated, results have shown that they can be effective on many patients and are done without anaesthesia and cause minimal discomfort.

    Grades 3 and 4

    Grade 3 – Haemorrhoid protrudes through the anus during straining or evacuation but needs to be manually returned to position.

    Grade 4 – Hemorrhoid remains prolapsed outside of the anus and cannot be manually returned to position.

    For treatment of Grade 3 and Grade 4 haemorrhoids, doctors will recommend surgical treatments. The most common surgical treatments are surgical haemorrhoid excision and surgical haemorrhoid stapling procedure.

     

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    Dr. Sim’s Special Interests

    Dr. Sim firmly believes that transdisciplinary care is the key to supporting both the elderly and complex patients through their perioperative and recovery journey.

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    • General Surgery
    • Complex anal fistula repair
    • Transanal Endoscopic Microsurgery (TEMS)
    • Laparoscopic and open colorectal surgery
    • Management of colorectal cancers and benign colorectal diseases
    • General anorectal conditions
    • Diagnostic and therapeutic endoscopy
    • Surgical management of inflammatory bowel disease
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