Dr Ng Chee Yung
Haemorrhoids, or piles, is very common. They are enlarged blood vessels, sometimes described as varicose veins, that occur inside, and around, the anal passage. These are small round lumps that you may feel on your anus, or even notice when they hang outside the anal canal.
Anyone can get haemorrhoids or piles, but they are more common as you get older. Haemorrhoids form when the naturally occurring blood vessels on the inside of the anal canal become larger and get engorged with blood. This can be caused by regular constipation and straining when trying to pass motion. Piles are also common during pregnancy with the change in hormone levels, and pressure of the baby on the pelvis. Being overweight and having a family history of piles also makes one more susceptible to the condition.
You should see your doctor if you notice lumps around your anus, especially if they cause you pain. Other notable symptoms include the presence of slimy mucus on your underwear, slimy mucus or bright red blood on the toilet paper after passing motion. You may also feel like your bowels haven’t been completely emptied after passing motion.
Piles may occur internally or externally. Both conditions may also occur together at the same time. Your symptoms may differ depending on the stage of your condition:
The best way to avoid getting piles is to prevent constipation, which can be achieved by maintaining a moderate-fibre diet, drinking plenty of water and exercising regularly. Try not to hold off bowel movements for too long, and avoid sitting on the toilet for an extended amount of time to read or use your mobile phone, as this puts extra pressure on the blood vessels in the anus.
Your piles may go away on their own with healthy lifestyle choices that reduce constipation such as maintaining a moderate-fibre diet, drinking plenty of water and exercising regularly.
However, if the piles are causing you pain, talk to your doctor about your treatment options. Your doctor will likely recommend medicated creams or ointments to ease your symptoms. These can be over-the-counter pain and anti-inflammatory medications you can get from the pharmacy. If the inflammation is severe, your doctor will prescribe a corticosteroid cream.
If the medications do not work, your doctor may recommend one of the following day procedures, in which you will be awake, but the area will be numbed to avoid discomfort:
If your piles improve over time, surgery will not be required. However, if medication and non-invasive procedures don’t work, or if your piles continue bleeding, your specialist may recommend the following surgical procedures:
Surgery should solve your pile problems. But with any surgical procedure, there are risks. These include excessive bleeding or infection. Others include:
Speak to your doctor about these potential risks, side-effects, and any other concerns you may have regarding the surgical treatment of piles.
You should call an ambulance or head straight to A&E if your symptoms change rapidly and you observe the following:
With proper management, you should be able to resolve any flare-up of haemorrhoids as they happen. However, if they are causing you pain or you notice bleeding, seek medical advice from a doctor.