Everything you need to know about piles

Piles, also known as haemorrhoids, affect many people at some point in their lives. Understanding piles can help you manage and treat this condition effectively. This guide covers what piles are, their causes, symptoms, available treatments, and the costs associated with treatment in Singapore.

What are piles?

Piles are swollen and inflamed veins located in the lower rectum and anus. They are classified into two types: internal and external. Internal piles develop inside the rectum and are generally not visible or painful. External piles form under the skin around the anus and can cause significant discomfort. Both types of piles are similar to varicose veins that occur in the legs.

Causes of piles

One of the primary causes is straining during bowel movements, often due to constipation. Straining increases the pressure on the veins in the rectal area, leading to swelling and the formation of piles. Chronic diarrhoea can also cause piles due to frequent bowel movements and irritation.

Prolonged sitting, especially on the toilet, can also contribute to piles. This is because sitting for extended periods can restrict blood flow to the rectal area. Occupations that require long periods of sitting, such as desk jobs, can increase the risk of developing piles.

Pregnancy is also a common cause of piles. During pregnancy, the growing uterus exerts pressure on the pelvic veins, which can lead to the formation of piles. Hormonal changes during pregnancy can also contribute to this condition.

Ageing is a significant factor, as the tissues supporting the veins in the rectum and anus can weaken and stretch over time. Obesity can also cause piles as excess weight increases abdominal pressure, which can affect the veins in the rectal area.

A diet low in fibre can lead to hard stools and straining during bowel movements, increasing the risk of piles.

Piles symptoms

The symptoms of piles can vary depending on whether they are internal or external. Internal piles are typically painless but can cause bleeding during bowel movements. You might notice small amounts of bright red blood on the toilet paper or in the toilet bowl. In some cases, internal piles can prolapse, or protrude outside the anus, which can be painful and cause discomfort.

External piles, on the other hand, can cause itching, swelling, and pain around the anus. These symptoms can be particularly bothersome during and after bowel movements. External piles can also bleed, especially if they are irritated by wiping or straining. In some instances, a hard lump may form near the anus, indicating a thrombosed haemorrhoid, which is a pile that contains a blood clot. This condition can be very painful and requires medical attention.

Other symptoms of piles include a feeling of fullness in the rectum, mucus discharge after a bowel movement, and discomfort or pain while sitting. If you experience any of these symptoms, it's important to seek medical advice to confirm the diagnosis and rule out other conditions.

Piles treatment

There are various treatment options for piles. For mild cases, lifestyle changes and home treatments can effectively alleviate symptoms. Increasing your intake of dietary fibre through foods like fruits, vegetables, and whole grains can help soften stools and reduce straining. Drinking plenty of water and staying hydrated can also improve bowel function and prevent constipation.

Over-the-counter creams, ointments, and suppositories can provide relief from itching and discomfort. These products often contain ingredients such as hydrocortisone, witch hazel, or lidocaine. Warm sitz baths, where you soak the affected area in warm water for about 15 minutes, can also help reduce swelling and pain.

For more severe cases, medical treatments may be necessary. Rubber band ligation is a common procedure for treating internal piles. It involves placing a small rubber band around the base of the pile, cutting off its blood supply, and causing it to shrink and fall off. Sclerotherapy is another option, where a solution is injected into the pile to shrink it. Coagulation techniques, using heat or light, can also be used to harden and shrink piles.

In some cases, surgical intervention may be required. A haemorrhoidectomy is the surgical removal of piles and is typically recommended for large or recurrent piles. Another surgical option is stapled haemorrhoidopexy, which involves stapling the pile back into place inside the rectum. While these procedures are effective, they are usually considered when other treatments have not been successful.

Can piles go away permanently?

Whether piles can go away permanently depends on various factors, including the severity of the condition and lifestyle choices. Many people can manage and even eliminate piles through lifestyle changes and medical treatments. However, the underlying factors that cause piles, such as chronic constipation or prolonged sitting, can lead to recurrence if not addressed.

Adopting a diet rich in fibre, staying hydrated, and avoiding prolonged sitting can significantly reduce the risk of piles returning. Regular exercise can also improve digestion and prevent constipation, further reducing the likelihood of developing piles.

While medical treatments can effectively alleviate symptoms and remove piles, there is always a possibility of recurrence if the contributing factors are not managed. Therefore, making lasting changes to your diet, exercise routine, and bowel habits is key to preventing piles from becoming a recurring issue.

Is piles treatment expensive in Singapore?

The cost of piles treatment in Singapore varies depending on the type of treatment and the healthcare provider. For mild cases that can be managed with over-the-counter medications and lifestyle changes, the cost is relatively low. 

Medical procedures can be more expensive. Rubber band ligation and sclerotherapy, which are commonly performed as outpatient procedures, can range from a few hundred to several thousand Singapore dollars, depending on the clinic and the complexity of the case. Coagulation procedures, which use heat or light, may also fall within this range.

Surgical treatments such as haemorrhoidectomy or stapled haemorrhoidopexy are more costly, often requiring hospitalisation and a longer recovery period. These procedures can cost more as they will include hospital fees, surgeon fees, and anaesthesia.

Many health insurance plans in Singapore cover piles treatment, so it is advisable to check with your insurer about the extent of coverage. Public healthcare institutions may offer more affordable options compared to private clinics, but waiting times might be longer. It is important to consider both the cost and the quality of care when choosing a treatment option.

Get Piles Treatment and Surgery in Singapore

Piles are a common condition that can be effectively managed with the right approach. A colorectal doctor can guide you to the best decision by helping you understand the causes, symptoms, and treatment options. 

The Colorectal Clinic focuses on providing specialist care for colorectal conditions in Singapore. If you need help with piles or know someone who does, contact us today.