These haemorrhoids are inside the rectum and may not be visible or cause discomfort initially. However, they can lead to painless bleeding during bowel movements or protrude through the anus when they become more advanced.
Piles Specialist Singapore
Dr Chok Aik Yong, a General and Colorectal Surgeon at Ascle Healthcare Group specialises in managing haemorrhoids (piles) and other colorectal conditions. He holds a Bachelor of Medicine and Surgery from the National University of Singapore and a Master of Medicine (Surgery) from Edinburgh (UK). Dr Chok incorporates minimally invasive procedures, including stapled haemorrhoidectomy, to provide a range of surgical and non-surgical treatment options tailored to individual patient needs.
Dr. Chok Aik Yong
MBBS | MRCS (UK) | MMed (Surgery) | FRCS (UK)
Types of Haemorrhoid Conditions Treated
Haemorrhoids can present in various forms, each requiring a specific approach to management. Dr Chok treats the following conditions:
Internal Haemorrhoids
External Haemorrhoids
External haemorrhoids located under the skin around the anus can cause itching, swelling, and pain. They may become more uncomfortable when irritated by straining or wiping.
Prolapsed Haemorrhoids
This condition occurs when internal haemorrhoids extend beyond the anal opening, leading to noticeable lumps. Prolapsed haemorrhoids can cause discomfort and may require manual reduction or medical intervention.
Thrombosed Haemorrhoids
When a blood clot forms within an external haemorrhoid, it becomes thrombosed, resulting in significant pain, swelling, and a hard lump near the anus. This condition often necessitates prompt medical attention.
Symptoms of Haemorrhoids
Recognising the symptoms of haemorrhoids is necessary for timely treatment. Common symptoms include:
- Rectal Bleeding: Noticing bright red blood on toilet paper or in the stool can indicate haemorrhoids. While often painless, it is necessary to consult a specialist to rule out other causes of bleeding.
- Pain or Discomfort: Experiencing discomfort or pain around the anal area, especially during sitting or bowel movements, may suggest the presence of haemorrhoids. This pain can range from mild to severe, depending on the type and severity of the haemorrhoid.
- Itching or Irritation: Persistent itching around the anus can result from haemorrhoids, leading to further irritation if scratched. This symptom often accompanies external haemorrhoids.
- Swelling or Lumps: Feeling a lump near the anus could be a prolapsed or external haemorrhoid. These lumps can be sensitive and may retract into the rectum or require medical assistance.
Diagnostic Methods
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Physical Examination
A visual inspection of the anal area helps identify external haemorrhoids or other abnormalities. This examination is typically quick and can provide immediate insights into the condition.
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Digital Rectal Examination (DRE)
By gently inserting a lubricated, gloved finger into the rectum, your doctor assesses for internal haemorrhoids or other issues. This procedure evaluates the strength and condition of the anal sphincter while identifying any abnormalities.
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Anoscopy
Using an anoscope, a small, tubular instrument, allows for a detailed view of the anal canal and lower rectum. This tool aids in identifying internal haemorrhoids and assessing their severity.
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Colonoscopy (if required)
A colonoscopy may be necessary if significant bleeding is present or when other gastrointestinal issues are suspected. This comprehensive examination visualises the entire colon to help rule out other conditions.
Treatment Options
Treatment plans are tailored to the specific type and severity of haemorrhoids. Dr Chok offers both non-surgical and surgical options.
Non-Surgical Treatment
Topical Medications
Prescription creams and ointments are available to help relieve inflammation, itching, and discomfort associated with haemorrhoids. These formulations often include active ingredients like hydrocortisone to reduce swelling and promote healing.
Rubber Band Ligation
Rubber band ligation involves placing a small rubber band around the base of an internal haemorrhoid to restrict its blood supply. This process causes the haemorrhoid to shrink, wither, and eventually fall off within a few days. The procedure is minimally invasive and generally does not require anaesthesia, making it a convenient option for many patients.
Injection
For this procedure, the doctor injects a chemical solution into the haemorrhoid, causing it to shrivel and fall off. This may be useful for bleeding haemorrhoids that are not prolapsed.
Surgical Treatment
Haemorrhoidectomy
Haemorrhoidectomy is a surgical procedure recommended for large, severe, or recurrent haemorrhoids that do not respond to other treatments. It is recommended for 3rd or 4th-degree piles or 2nd-degree piles that have failed other treatments, such as rubber band ligation. The haemorrhoidal tissue is carefully excised during the procedure to provide lasting relief. This procedure under anaesthesia ensures patient comfort and typically requires a short recovery period in a controlled setting.
Stapled Haemorrhoidectomy
Stapled haemorrhoidectomy is a minimally invasive technique for treating prolapsed haemorrhoids. It involves repositioning the haemorrhoids and reducing their blood supply with a specialised stapling device. Compared to traditional haemorrhoidectomy, this method often results in less post-operative pain and a faster recovery, making it an effective option in some instances.
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Frequently Asked Questions (FAQ)
What are the main risk factors for haemorrhoids?
Haemorrhoids often develop due to increased pressure in the rectal area. Common risk factors include chronic constipation, prolonged sitting, straining during bowel movements, pregnancy, and obesity, all of which can weaken vein walls over time.
How long is the recovery period after haemorrhoid treatment?
Recovery times vary depending on the treatment. Non-surgical methods may involve minimal downtime, while surgical procedures like haemorrhoidectomy may require two weeks to recover. Patients can resume normal activities gradually.
Can haemorrhoids recur after treatment?
Recurrence is possible, especially if contributing factors such as constipation or prolonged sitting persist. Adopting preventive measures, including a fibre-rich diet, adequate hydration, and regular physical activity, can reduce the likelihood of recurrence.
Dr. Chok Aik Yong
MBBS|MRCS (UK)|MMed (Surgery)|FRCS (UK)
Expertise lies in managing colorectal diseases, particularly advanced colorectal cancer and inflammatory bowel disease.
- Dr Chok graduated with degrees in Bachelor of Medicine and Surgery from the National University of Singapore. He was conferred the Master of Medicine (Surgery) in Edinburgh (UK) and a member of the Royal College of Surgeons, UK. He subsequently completed his specialist training in colorectal surgery and became a Fellow of the royal college of Surgeons in Edinburgh in 2016.
- Dr Chok was awarded the Health Manpower Development Plan (HMDP) award in 2019 to further advance his colorectal training at Royal Marsden Hospital, one of the top 5 cancer centres in the world. While in London, Dr Chok trained with pioneers in the surgical management of advanced colorectal cancer and inflammatory bowel disease (IBD) and gained extensive experience while appraising the latest clinical and research evidence.
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