Haemorrhoids

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士

What are Haemorrhoids?

Haemorrhoids, also known as piles, are swollen veins in the lowest part of the rectum and anus. When the walls of these blood vessels stretch, they become irritated and swollen, causing haemorrhoids.

This condition can lead to discomfort, itching, pain, and sometimes bleeding. While haemorrhoids are usually not dangerous, they can significantly impact daily life and require proper management.

Types of Haemorrhoids

Haemorrhoids are classified into different types according to their location and characteristics.

Internal Haemorrhoids

Internal haemorrhoids are located inside the rectum and are not visible from the outside. They are usually painless because the rectum lacks pain receptors, making internal haemorrhoids less painful than external ones. Internal haemorrhoids can prolapse or extend outside of the anus, causing additional discomfort and complications.

External Haemorrhoids

External haemorrhoids develop beneath the skin around the anus and can be seen and felt as painful lumps, especially when sitting or during bowel movements. They can also cause swelling or tenderness around the anus.

Thrombosed Haemorrhoids

Thrombosed haemorrhoids occur when a blood clot forms within an external haemorrhoid, causing severe pain and swelling. This clot can create a hard, swollen, and inflamed lump around the anus.

Prolapsed Haemorrhoids

These are internal haemorrhoids that have stretched and protruded outside the anal opening. They may return on their own or be gently pushed back into place. Prolapsed haemorrhoids can cause discomfort and irritation, particularly if exposed to friction from clothing.

Causes of Haemorrhoids

Haemorrhoids can develop from a variety of factors, including:

Ageing

The vein-supporting tissues in the rectum and anus may weaken and extend with age. As the tissues deteriorate, the veins become more prone to swelling and haemorrhage. This risk is worsened by age-related bowel habit changes, such as increased constipation.

Pregnancy

During pregnancy, the growing uterus compresses the veins in the lower rectum and anus, while hormonal changes soften the vein walls. This increases the likelihood of swelling and raises the risk of haemorrhoids in pregnant women.

Chronic Constipation or Diarrhoea

Constipation leads to straining and increased pressure on rectal veins. Chronic diarrhoea can cause continuous irritation and inflammation of the anal and rectal area, weakening the vein walls and promoting haemorrhoid development.

Obesity

Excess body weight puts pressure on the pelvic veins, particularly in the abdominal area, which can cause haemorrhoids.

Genetics

A genetic predisposition to developing haemorrhoids can be a contributing factor. You may be more likely to develop the condition if it runs in your family, as genetics can influence the strength and elasticity of the vein walls in the anal and rectal areas.

Symptoms

Haemorrhoids can cause a variety of symptoms, ranging in severity. Common symptoms include:

Bleeding: One of the most common signs is bright red blood during or after bowel movements, which indicates that the haemorrhoids are irritated or damaged.

Itching and Irritation: The swollen veins can inflame the surrounding skin, leading to persistent itching and irritation around the anus.

Pain and Discomfort: Haemorrhoids can cause pain, especially during bowel movements or when sitting for long periods, due to the pressure on the swollen veins.

Lumps: Protruding lumps around the anus are a clear sign of haemorrhoids, often tender to the touch and causing further irritation.

Mucus Discharge: The presence of haemorrhoids can lead to a mucus discharge, which may cause a feeling of wetness, adding to the irritation and itching in the anal area.

Diagnosis

Medical History

The doctor will review your symptoms, lifestyle, bowel habits, and family history to understand the possible causes and severity of your condition.

Physical Examination

The doctor will examine the anal and rectal areas for signs of haemorrhoids through:

  • Visual Inspection: Checking the area around the anus for external haemorrhoids.
  • Digital Rectal Examination (DRE): Using a gloved finger to feel for internal haemorrhoids or lumps.

Endoscopic Procedures

If further examination is needed, the doctor may use:

  • Anoscopy: A short tube to view the anal canal.
  • Proctoscopy: A longer tube for a deeper look into the rectum.
  • Sigmoidoscopy: A flexible tube to check the lower colon and rectum.
  • Colonoscopy: A thorough examination of the entire colon to rule out serious conditions like cancer.

Treatment Options

Treatment for haemorrhoids varies according to the severity, type, and symptoms.

Medication

Topical creams and ointments containing hydrocortisone or witch hazel can reduce pain, itching, and inflammation when applied to the affected area. For internal haemorrhoids, medical suppositories inserted into the rectum can relieve pain and swelling. Additionally, non-prescription pain relievers like acetaminophen or ibuprofen can help manage overall discomfort.

Minimally Invasive Procedures

Minimally invasive procedures may be recommended for haemorrhoids that are persistent or severe and do not respond to nonsurgical treatments. These include:

Rubber Band Ligation

A small rubber band is placed around the base of an internal haemorrhoid to cut off its blood supply. The haemorrhoid shrinks and falls off within three to four days with minimal discomfort.

Injection Sclerotherapy

This procedure injects a chemical solution into the haemorrhoid tissue, causing it to shrink and eventually disappear. Injection sclerotherapy is effective for small internal haemorrhoids and can be performed quickly with minimal discomfort.

Transanal Haemorrhoidal Dearterialization (THD)

This procedure uses a Doppler ultrasound device to locate the blood vessels supplying the haemorrhoids. The blood flow is then interrupted, causing them to shrink. THD is less invasive than traditional surgery and has a quicker recovery time.

Surgical Treatment

If other treatments are ineffective or the haemorrhoids are particularly large or painful, surgical options may be considered.

Haemorrhoidectomy

Small incisions are made around the haemorrhoidal tissue to remove the enlarged blood vessels, after which the incisions are stitched. This is typically performed under general anaesthesia and is highly effective for treating severe or recurrent haemorrhoids but involves a longer recovery period.

Stapled Haemorrhoidectomy

This procedure removes haemorrhoidal tissue with a circular stapling device, repositioning the haemorrhoids and disrupting their blood supply, causing them to shrink. Stapled haemorrhoidectomy is less painful than traditional haemorrhoidectomy and has a quicker recovery time.

Are Your Haemmorhoid Symptoms Affecting Your Quality Of Life?

Consult our haemmorhoids specialist for an accurate diagnosis and a personalised treatment plan today.

Prevention Measures

Adopting a healthier lifestyle can reduce and prevent certain haemorrhoid symptoms.

A diet high in fibre, found in fruits, vegetables, and whole grains, helps soften stools and promotes regular bowel movements, which reduces the need for straining during defecation.

In addition to dietary changes, regular physical activity, such as walking and swimming, helps improve bowel function and reduce constipation.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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    Frequently Asked Questions

    Can haemorrhoids return after treatment?

    Although haemorrhoidectomy is highly effective in treating severe haemorrhoids, there is a chance of recurrence. Recurring haemorrhoids can be avoided by maintaining healthy habits such as eating a healthy diet, exercising regularly, and avoiding long periods of sitting.

    Can I return to work after haemorrhoid surgery?

    The ability to return to work after haemorrhoid surgery depends on the nature of your job and your recovery. Most people can return to non-strenuous work within a week, but those with physically demanding jobs may need a longer recovery period.

    Will I need follow-up appointments after haemorrhoid treatment?

    Yes, follow-up appointments are recommended to monitor recovery and ensure the haemorrhoids have been effectively treated. Your doctor will schedule these appointments to check for complications and address any ongoing symptoms or concerns.

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