Haemorrhoids
What are Haemorrhoids?
Haemorrhoids, also known as piles, refer to swollen and distended veins in your anus and lower rectum, similar to varicose veins. They are very common, affecting one in three Singaporeans and nearly half of the population at some stage in their lives. There are two types of haemorrhoids:
– External haemorrhoids – When haemorrhoids develop near the anus, covered by extra sensitive skin. The external haemorrhoid feels like a hard and sensitive lump and bleeds only if ruptured. Painful swelling may occur if a blood clot develops in one of them.
– Internal haemorrhoids – When haemmorhoids develop inside the rectum and anal canal beneath the lining. Painless bleeding and protrusion when passing stool are the most common symptoms. They usually cannot be seen or felt and rarely cause discomfort. However, severe pain may arise if it protrudes from the anal opening and cannot be pushed back inside.
Signs and Symptoms usually depend on the type of haemorrhoid:
– External haemorrhoids
– Itching or irritation in the anal region
– Discomfort or pain
– Swelling around the anus
– Bleeding
– Internal haemorrhoids
– Painless bleeding when passing stool. Small amounts of bright red blood may be observed in the toilet or on toilet tissue.
– A hemorrhoid pushes through the anal opening (prolapsed/protruding haemorrhoid), which causes pain and irritation.
Diagnosis and Management
External haemorrhoids will often be visible by your doctor. Diagnosing internal haemorrhoids however will include an examination of your anal canal and rectum. This examination may take the form of a digital examination whereby Dr Ong inserts a gloved, lubricated finger into your rectum to feel for unusual growths and haemorrhoids. A visual inspection may also be used as internal haemorrhoids are often too soft to be felt, which involves the examination of the rectum and lower part of the large intestine using an anoscope, proctoscope, or sigmoidoscope. Additionally, Dr Ong may recommend an examination of your entire colon using colonoscopy (lower endoscopy) if you have risk factors for colorectal cancer.
Management options include:
– Home remedies – Home remedies may relieve mild pain and swelling of haemorrhoids. This includes using topical treatments, oral pain relievers, and eating high-fiber foods.
– Medication – Over-the-counter creams, ointments, suppositories, or pads may be used to relieve pain and itching. Please consult Dr Ong before purchasing steroid creams and applying them. stapling may be recommended.
– External haemorrhoid thrombectomy- If a painful blood clot (thrombosis) forms within an external haemorrhoid, it may be removed through this procedure and provide prompt relief. Performed under local anaesthesia, this procedure is most effective if done within 3 days of developing a clot.
– Minimally invasive procedures – Often recommended for persistent bleeding or painful haemorrhoids, Dr Ong may recommend a minimally invasive procedure which does not require anaesthesia or any outpatient setting. Options include rubber band ligation, injection (sclerotherapy), and coagulation (infrared, laser or bipolar).
– Surgical procedures – Very few people with haemorrhoids require surgery. However, if other management options are unsuccessful or if the haemorrhoids are large, surgical options such as haemorrhoid removal (haemorrhoidectomy) or haemorrhoid
Other symptoms
Vomiting, Nausea,
Abdominal Pains
Bloatedness
Stomach Pain
Blood in stool
Diarrhoea, Constipation
and Intestinal Pain