Hemorrhoids (Piles) Treatment in Singapore

What Are Hemorrhoids?

Everyone has small cushions of blood vessels in the anal canal that help control bowel movements. Hemorrhoids happen when these cushions become swollen and enlarged. When that occurs they can bleed, itch, ache or slip down out of place.

Piles are one of the most common reasons people see a general surgeon for a bowel complaint. They become more likely with straining, constipation, pregnancy, long periods of sitting and increasing age. Many cases are mild and short lived, but some need treatment to settle properly.

Hemorrhoids vs Piles: Are They the Same Thing?

Yes. Piles is simply the everyday word for the same condition doctors call haemorrhoids. There is no medical difference between the two terms. You may hear either used during your consultation.

Types of Hemorrhoids

Piles are grouped by where they sit and how far they have moved.

Internal Hemorrhoids

These form higher up, inside the rectum. They usually cause no pain because that area has few pain sensors. The most common sign is bright red bleeding during or after a bowel movement. Larger ones may prolapse, meaning they slip down towards or out of the anus

External Hemorrhoids

These sit under the skin around the anus and can often be felt as a lump. They are more likely to be sore or itchy, and can become quite painful if a small blood clot forms inside one, known as a thrombosed pile.

Internal vs External Hemorrhoids

Feature	Internal	External
Location	Inside the rectum, above the anal opening	Under the skin around the anus
Pain	Usually painless	Can be painful, especially if clotted
Bleeding	Bright red bleeding is common	Bleeding is less common
What you notice	Fullness, or a lump that prolapses	A lump or swelling you can feel

Hemorrhoid Grades (Stages)

Grade 1: small, stay inside, may bleed
Grade 2: prolapse when straining, then slip back on their own
Grade 3: prolapse and need to be pushed back by hand
Grade 4: stay prolapsed and cannot be pushed back

Consult Our Specialists to check your Hemorrhoid Grades

Symptoms of Hemorrhoids

Symptoms depend on the type of pile, and some people have no symptoms at all. The common signs to look out for are:

Bright red bleeding during or after a bowel movement, usually painless
Itching or irritation around the anus
A soft lump or swelling at the edge of the anus
A bulge of tissue that comes down from the back passage, known as a prolapse
Discomfort, soreness or aching in the anal area
Mucus discharge or soiling of the underwear
Difficulty cleaning after a bowel movement

What Do Hemorrhoids Look Like?

External piles often appear as one or more soft lumps or swellings at the edge of the anus. A clotted one can look bluish or purple and feel firm. Internal piles usually cannot be seen from the outside unless they have prolapsed.

Bleeding Hemorrhoids

Bleeding from internal piles is typically bright red, seen on the toilet paper, in the bowl or on the surface of the stool. It is usually painless. Bleeding tends to come and go and often follows a hard or strained bowel movement.

When to get bleeding checked: See a doctor about any rectal bleeding, particularly if the blood is dark, mixed through the stool, or comes with a change in bowel habit, weight loss or new symptoms after the age of 40. Piles are a common cause of bleeding, but not the only one, so it is worth confirming. See our related guide on blood in stools.

Symptoms in Women

Symptoms are much the same as in men. Women are more prone to piles during pregnancy and after childbirth, when extra pressure in the pelvis and straining make them more likely. These often improve after delivery.

Symptoms in Men

Men tend to develop piles from straining, heavy lifting and long periods of sitting. The signs are the same: bleeding, itching, a lump or discomfort around the back passage.

What Causes Hemorrhoids?

Piles develop when there is repeated or increased pressure on the veins around the anus. Common contributors include:

Constipation, hard stools and straining on the toilet
A diet low in fibre
Sitting for long periods, including long spells on the toilet
Pregnancy and childbirth
Carrying extra weight
Heavy lifting
Ageing, as the supporting tissue weakens over time
Ongoing diarrhoea

Book a Consultation

How to Treat Hemorrhoids

Most piles improve with simple changes. If they keep bleeding, prolapse or do not settle, a general surgeon can offer a clinic procedure or, in more advanced cases, surgery. The table gives a quick overview, with detail below

Approach	What it involves	Usually suited to
Care at home	More fibre and fluids, warm baths, not straining, not sitting long on the toilet	Mild or first flare-ups
Pharmacy relief	Creams, ointments, suppositories, stool softeners, simple pain relief	Easing symptoms while piles settle
Clinic procedures	Rubber band ligation, injection (sclerotherapy) or infrared coagulation, done in minutes without general anaesthetic	Internal piles that bleed or prolapse, roughly grades 1 to 3
Surgery	Removal (haemorrhoidectomy), stapling, or an artery ligation procedure under anaesthetic	Large, prolapsed or persistent piles, roughly grades 3 to 4

Home Remedies for Piles

Eating more fibre, drinking enough water and avoiding straining will ease most mild piles. Short warm baths can soothe soreness, and it helps to avoid delaying a bowel movement. These steps relieve symptoms rather than cure the cause, so see a doctor if there is bleeding or the problem lingers.

Medication for Hemorrhoids

Pharmacies stock creams, ointments, suppositories and medicated wipes that calm itching and discomfort for a short time. A stool softener or fibre supplement can make bowel movements easier, and simple pain relief may help. These ease symptoms but do not remove the piles.

Treating Piles Without Surgery

Many piles are treated in the clinic without surgery. Rubber band ligation places a tiny band at the base of an internal pile so it shrinks and drops off. Sclerotherapy injects a solution to close it off, and infrared coagulation uses heat to do the same. These take only minutes and most people return to normal activities quickly.

Treating External Hemorrhoids

External piles usually settle with the measures above over a week or two. A painful thrombosed one may be relieved by a minor procedure to release the clot, which works best within the first day or two of the pain starting.

Treating Internal Hemorrhoids

Internal piles are treated by grade. Lower grades respond well to banding or injection in the clinic, while larger or grade 4 piles that stay prolapsed are more likely to need surgery to give lasting relief.

Relieving Hemorrhoid Pain

Warm baths, a cold pack, soothing topical products and a stool softener all help with pain. Significant pain usually points to a thrombosed external pile, which is worth having assessed, as early treatment can shorten the discomfort.

Treating Bleeding Pile

Softening the stools and avoiding straining often reduces bleeding on its own. For internal piles that keep bleeding, banding or injection in the clinic usually stops it. Any bleeding that is heavy, persistent or unusual should be reviewed first.

Consult a Specialist

When to See a Doctor, and Can Piles Be Cured?

See a general surgeon if you have bleeding, ongoing pain, a pile that will not go back in, symptoms that do not improve within a week or two, or piles that keep coming back. Getting checked also rules out other causes of the same symptoms.

Mild piles often clear up with simple measures. When treatment is needed, clinic procedures and surgery are effective at settling problem piles for good. New ones can still form later if the habits that caused them continue, which is why the changes under prevention matter.

How to Prevent Hemorrhoids

Eat plenty of fibre from fruit, vegetables and wholegrains
Drink enough water through the day
Avoid straining and do not sit on the toilet longer than needed
Stay active and keep to a healthy weight
Go when you need to rather than holding on
Treat constipation early before stools harden

Hemorrhoids are treated as part of our general surgery service. Dr Julian Wong and Dr Tang Tjun Yip are Senior Vascular and General Surgeons, both dual accredited in the UK and Singapore and registered with the Singapore Medical Council and the General Medical Council. Between them they hold close to 50 years of surgical experience. Dr Wong trained and practised as a Consultant General and Vascular Surgeon in the NHS in the UK before returning to Singapore, and previously headed a hospital surgical division here. He also serves as an examiner for the Royal Colleges of Surgeons and as Chief Examiner for the MRCS.

Request an Appointment

Frequently Asked Questions

Can you push hemorrhoids back in?

Often yes. A prolapsing internal pile can usually be eased back gently. If it will not stay in or is painful, see a doctor.

Do piles go away on their own?

Mild piles often settle within a week or two with simple measures. Ones that bleed, prolapse or keep returning should be reviewed.

Can hemorrhoids cause mucus discharge?

Yes. Prolapsing internal piles can leak a little mucus and cause itching or irritation around the anus

Can piles cause stomach pain?

No. Piles cause discomfort around the back passage, not the stomach. Abdominal pain points to another cause worth checking.

Why do hemorrhoids make me feel like I need to go?

An enlarged internal pile can create a sensation of fullness or incomplete emptying, which feels like needing to pass a stool.

Are bleeding piles dangerous?

Bleeding is usually minor, but it should always be checked, as other conditions can cause similar bleeding

Do I need surgery for piles?

Most people do not. Surgery is kept for large, prolapsed or persistent piles that do not respond to simpler treatment.

How long do piles last?

A mild flare-up often eases within a few days to a couple of weeks. Persistent piles need treatment to settle.

References

10. NHS. Piles (Haemorrhoids). nhs.uk/conditions/piles-haemorrhoids
11. Mayo Clinic. Hemorrhoids.
https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
12. Cleveland Clinic. Hemorrhoids. my.clevelandclinic.org/health/diseases/15120-hemorrhoids
13. Johns Hopkins Medicine. Hemorrhoids.
hopkinsmedicine.org/health/conditions-and-diseases/hemorrhoids

Book an Appointment

Hemorrhoids (Piles)