Piles / Haemorrhoids

These are lumps located at the anus. They are actually enlarged blood vessels. Therefore when bleeding occurs, the bleeding can be quite brisk. Patient have described the blood dripping down to the toilet bowl like an open tap.


Piles can be internal or external.

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Understand your Problems

Piles are also known as haemorrhoids. This is a very common condition and frequently occurs without any apparent cause or symptom. Some people might not even be aware that they have piles. Common symptoms include bleeding after passing out stools, swelling around the anus, pain or itch around the anus.


Constipation, straining during bowel movement or prolonged duration of bowel movement are associated with the formation of piles. Pregnancy also predisposes to piles. This is due to the baby in the mother’s womb pressing on the large blood vessels in the back, causing back pressure down the veins leading to piles. Piles frequently present with bleeding. However, colorectal cancer can also cause bleeding, and it is not possible to distinguish between the two unless special tests are performed.


Seek for Treatments

There are many treatment methods for piles. The type of treatment chosen depends on the severity of the disease. The common methods include: Medication, dietary modification, local therapy such as rubber-band ligation of piles and surgery.


In the early stages, dietary modification and / or medication would be enough. For the smaller piles, sometimes local treatment options such as rubber-band ligation or HET may be needed. In the later stages, such measures may not be good enough, and surgery may be required to treat the piles. This is especially so if the haemorrhoids prolapse out of the anus and cannot be pushed back in. Your doctor will advise you which method is most suitable for you.


There are several types of surgical treatments for haemorrhoids.

Conventional/ Open haemorrhoidectomy
  • The piles are excised, or cut off.
  • This can be performed using different types of instruments.
  • Care is taken to make sure that there is no bleeding, and that not too much tissue is removed.
  • The wound is usually left open to heal by itself.
Stapler haemorrhoidectomy
  • Special stapler is used to remove tissue in the rectum, and pull the haemorrhoids back into the anus, and reducing the blood supply to the haemorrhoids.
  • The blood supply to the haemorrhoids is reduced, and the haemorrhoids will gradually shrink in size.
  • The surgical wound is within the rectum, and there is no external wound, unless anal skin tags are removed at the same sitting.
Transanal haemorrhoidal dearterialization (THD)
  • In THD, a special instrument is inserted into the anus.
  • Using an ultrasound probe, the location of blood vessels supplying the haemorrhoids is identified, and these blood vessels are tied off.
  • If there is excessive tissue, these tissues can be stitched together, thus pulling the haemorrhoids back into the anal canal.

Some people may think that piles will go away by avoiding spicy or fried foods. These are myths without strong scientific evidence. However, lifestyle modifications such as exercising regularly, increasing fibre intake (e.g. fruits and vegetables) and drinking plenty of water so as to avoid constipation does help in preventing piles or prevent piles from becoming worse.


If you have symptoms such as bleeding when you move your bowel, pain, swelling or itch around the anus area, you should get a proper assessment. Early diagnosis will help you because you can take steps to prevent it from worsening, and also to rule out other more serious problems like colon cancer.

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