Piles (or haemorrhoids) are very common in Singapore. They are characterised by pain and a sensation of a lump in the anal region, as well as bleeding during bowel movements.
Piles are enlarged blood vessels found within the inner lining of the rectum or the surface of the anus. Some may be located within the anal canal, while some may protrude outside of it.
Typically, these blood vessels do not cause any issue. However, with repeated and/or excessive pressure (e.g. chronic constipation, childbirth), the blood vessels may swell and become inflamed. And as the wall of the blood vessels stretch, they may break upon pressure, resulting in bleeding.
Dr Chew has been involved in various research studies evaluating the effectiveness and safety of various haemorrhoid surgical procedures.
WHAT ARE THE TYPES OF PILES?
Internal Piles: These piles develop within the rectum and usually does not cause any pain or discomfort. However, some may protrude from the anal canal upon straining. In mild cases, the piles can be manually pushed back in; in more serious cases, the protruding piles are unable to be pushed back into the anal canal.
External Piles: External piles develop around the anus, and is characterised by a lump near or around the anus. They may cause pain, itching and bleeding; and are not reducible. External piles are at risk of developing sudden and painful blood clots (thrombosis).
Thrombosed Piles: Thrombosed piles are piles that are filled with blood clots. They present with severe symptoms such as intense pain, burning, itching and swelling. They must be quickly treated to prevent the loss of blood supply and tissue damage.
PILES TREATMENT SINGAPORE
Treatment varies, depending on the type and severity of the piles. Piles or haemorrhoid surgery will only be needed in more advanced cases.
This centres around reducing constipation and symptomatic relief. You may be recommended to increase your fibre intake (not excessively) or take laxatives in order to soften your stools. You may also try sitting in a warm sitz bath to help relax the anal muscles, provide pain relief and improve blood flow. Topical creams or oral medication may also be used to temporarily ease inflammation and itching and other symptoms.
MINIMALLY INVASIVE PROCEDURES
Should the above conservative methods not work, your piles surgeon may recommend minimally invasive treatments such as rubber band ligation.
In the first method, a rubber band will be placed around the base of the piles, restricting its blood supply and causing it wither and die off within a few days.
PILES SURGERY SINGAPORE
In cases where the above conservative and minimally invasive methods prove insufficient, piles surgery (haemorrhoidectomy) may then be recommended. This can be mainly done through the conventional, stapled method or via a new method known as laser haemorrhoidectomy.
In the conventional method, this method has been used for many years and is an effective method will excision of the piles and skin tags. This method is suitable in many type of piles and is still commonly performed.
In the stapled method, the piles are removed through a circular stapling device without the need for an incision. Piles excised in this fashion have been reported to have less post operative pain. Speak to us to find out if you are suitable for this.
In one of the newest methods, laser haemorrhoidectomy has been performed by our surgeon. This method requires a small incision and insertion of a laser probe inserted into the pile. The initial results suggest equivalent short term outcomes but with less post operative discomfort.
Chew MH; Tan WS; Eu KW
The use of CEEA 34 in stapled hemorrhoidectomy: suggested modifications in technique.
World journal of surgery 2008; 32(6):1160-1111 (Article; Published in Print)
Ng KH; Chew MH; Eu KW
Modified stapled haemorrhoidectomy: a suggested improved technique.
ANZ journal of surgery 2008; 78(5):394-377
Chew MH; Chiow A; Tang CL
Keloid formation after stapled haemorrhoidectomy causing anal stenosis: a rare complication.
Techniques in coloproctology 2008; 12(4):351-322 (Letter; Published in Print)
Chew MH; Kam MH; Lim JF; Ho KS; Ooi BS; Tang CL; Eu KW
The evaluation of CEEA 34 for stapled hemorrhoidectomy: results of a prospective clinical trial and patient satisfaction.
American journal of surgery 2009; 197(6):695-701 (Article; Published in Print)