What Are Piles?
Piles, medically known as haemorrhoids, refer to inflamed blood vessels that develop inside the anal canal or on the skin around the anus. There are two types, which are:
- External piles – These develop from a blood clot that forms a painful and swollen lump, which can rupture and cause bleeding. External piles typically result from overstraining during bowel movements.
- Internal piles – These commonly form in the upper part of the anal canal, and caused by overstraining that stretches and breaks the wall of the blood vessel. They can prolapse and protrude outside the anus during bowel movements, but they can go back on their own, or be pushed back inside.
What Causes Piles?
An increased pressure in the veins is the most common cause of piles. Such pressure can develop from activities such as overstraining during bowel movements, sitting too long on the toilet, consistent heavy lifting and adopting a low-fiber diet. Age, chronic diarrhea and constipation, pregnancy and childbirth can also cause haemorrhoids.
What Are the Symptoms of Piles?
Most piles are asymptomatic and resolve on their own. In some cases, patients may experience bleeding during bowel movements, and itching or pain in the anal area, or see or feel a hard lump in or around the anus. However, such signs are typically indicative of an underlying medical issue such as an anal fissure or colon cancer.
Are Piles Serious?
Piles are generally harmless and not life-threatening. However, internal haemorrhoids can be classified into four levels of severity according to their size and location.
- First degree – Haemorrhoids are inside the anal canal, and there is no apparent lump on the outer anus.
- Second degree – Larger piles bulge out the anus during bowel movements. When straining stops, the bulge goes back on its own.
- Third degree – Also known as prolapsed haemorrhoids, these piles come out during bowel movements and hang from the rectum afterwards. They can be pushed back in manually.
- Fourth degree – Piles can no longer be re-inserted into the anus. Such types require more aggressive forms of piles treatment in Singapore, including piles surgery.
How Are Piles Treated?
Most piles do not require treatments, but some do, depending on the degree of severity and impact to the patient’s quality of life. For mild cases, reducing straining or laboring while passing stool is enough to alleviate symptoms. Staying hydrated or taking laxatives and suppositories (if prescribed by a doctor or piles surgeon) helps as well.
For haemorrhoids that cannot be resolved through conservative means, treatment options include:
- Rubber band ligation – This procedure involves placing an elastic band tightly around the haemorrhoid to cut off its blood supply.
- Sclerotherapy – A special fluid is injected into the haemorrhoid to shrink it.
- Ultrasound-guided haemorrhoidal artery ligation – The affected arteries are detected using an ultrasound probe, then sutured to cut off the blood supply and shrink the haemorrhoid.
For the most severe cases, Singapore piles surgery, known as a haemorrhoidectomy, is recommended. This can be done in one of two ways:
- Conventional haemorrhoidectomy – Piles are surgically excised from outside the anal canal.
- Staple haemorrhoidectomy – This procedure involves re-inserting the piles back into the anus, then cutting them from the inside. The cur edges will be closed with titanium staples. Compared to conventional haemorrhoidectomy, this technique causes less pain.