Thomas Ho SURGERY

All You Need to Know About Piles (Haemorrhoids)

Causes, Symptoms, and Getting Treated with Dr. Thomas Ho

What are Haemorrhoids?

Haemorrhoids – or piles – may present as lumps around or inside your anus.

This 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.

What are Haemorrhoids?

Haemorrhoids – or piles – may present as lumps around or inside your anus.

This 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.

Dr Thomas Ho

Senior Consultant General Surgeon & Medical Director

MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery), FSSO(USA)
20+ Years Surgical Experience
2000+ Completed Surgeries
Accredited Surgical Oncologist (MOH-Scholar)
Formerly Head of Surgical Department @ Woodlands Health Campus
Founded the Head & Neck Surgical and Surgical Oncology Service @ Tan Tock Seng Hospital

Dr Thomas Ho

Senior Consultant General Surgeon & Medical Director

MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery), FSSO(USA)
20+ Years Surgical Experience
Accredited Surgical Oncologist (MOH-Scholar)
Formerly Head of Surgical Department @ Woodlands Health Campus
Founded the Head & Neck Surgical and Surgical Oncology Service @ Tan Tock Seng Hospital

What are the symptoms of Haemorrhoids?

The symptoms for haemorrhoids are varied and include:

Itching around the anus
Passage of blood during bowel movements
Fresh blood dripping into the toilet bowl or upon wiping
Moist mucus on the underwear despite cleaning properly after visiting the toilet
Lumps felt around the anus especially after bowel movement
Painful lumps that need to be pushed back into the anus

If you experience these persistent symptoms, we advise that you consult a Doctor.

External Haemorrhoids

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

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.

Treatment of Haemorrhoids

(Non-surgical options)

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.

Surgical Treatment of Haemorrhoids

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.

If you experience the symptoms we have covered and suspect that you might be suffering from Haemorrhoids, book a consultation with Dr. Thomas Ho to get a proper diagnosis: