Haemorrhoids or piles are a common problem in Singapore.
Haemorrhoids, commonly known as piles in Singapore, are swollen or inflamed veins that can develop inside the rectum or outside the anus. Approximately 1 in 3 Singaporeans suffer from haemorrhoids, and although piles seem abnormal, they are present in everyone. These blood vessels support our bowel movements, often cushioning the process. However, when blood vessels become swollen or inflamed, symptoms such as pain and discomfort will occur.
There are three types of haemorrhoids are:
- Internal haemorrhoids: develops inside the rectum and are not visible from the outside. It often causes bleeding without pain as no pain receptors exist on the internal rectum. However, they may cause discomfort and pain if they protrude from the rectum and become more inflamed.
- External haemorrhoids: develops outside the anal opening and can be seen and felt from the outside. It often causes itching, pain, and sometimes bleeding when irritated or during bowel movements.
- Thrombosed haemorrhoids: occur due to a clot in the haemorrhoid. Individuals can feel a hard lump at the site and experience symptoms such as pain, swelling, and bleeding.
Haemorrhoids can also be further categorised into stages based on severity; these stages are:
- Stage 1: the haemorrhoids do not extend outside the rectum.
- Stage 2: the haemorrhoids occasionally extend outside the rectum but can reduce spontaneously.
- Stage 3: the haemorrhoids extend outside the rectum and require help to reduce.
- Stage 4: the haemorrhoids are constantly extended outside the rectum and cannot be reduced. External haemorrhoids and thrombosed haemorrhoids are usually classified as Grade 4.
Haemorrhoids are classified into stages depending on their severity.
The symptoms of haemorrhoids vary depending on the individual, the severity of the condition, and whether the haemorrhoids are internal, external or thrombosed. In general, symptoms include:
- Bleeding that occurs during or after bowel movements
- Itching and discomfort
- Irritation
- Aching and pain
- Prolapse (protrusion)
- Swelling and inflammation
- Mucus discharge
While the above are common symptoms associated with haemorrhoids, other conditions like anal fissures, anal abscesses, and even colorectal cancer may present similar symptoms. If you are experiencing any of these symptoms, especially if they are becoming more severe, seek medical attention for a proper diagnosis and appropriate treatment recommendations.
If you are experiencing any of the symptoms stated above, book an appointment with Alpine Surgical Practice today.
Haemorrhoids often develop over time due to increased pressure in the veins of the rectum and anus. Several factors lead to this pressure, including:
- Straining during bowel movements
- Chronic constipation or diarrhoea
- Prolonged sitting or standing
- Obesity
- Pregnancy
- Heavy lifting
- Poor diet that lacks dietary fibre
- Ageing
Pregnancy and other issues, such as chronic constipation, can increase pressure in the veins of the rectum and anus, thus resulting in haemorrhoids or piles.
Yes, haemorrhoids can cause pain, although it depends on whether haemorrhoids are internal or external. External haemorrhoids that have become enlarged often cause more pain than internal haemorrhoids. Internal and external haemorrhoids can also cause discomfort, irritation, and itching.
Haemorrhoids can affect people of all ages and backgrounds in Singapore. However, certain factors may increase the risk of developing haemorrhoids; these risk factors include:
- Age: as people age, the risk of developing haemorrhoids increases. This is due to the weakening of tissues that support the veins in the rectum and anus.
- Lifestyle: sedentary lifestyles and lack of regular exercise can also play a role, as well as a low-fibre diet that is also high in processed and fatty foods. This may cause constipation, which increases the risk of haemorrhoids due to pressure and straining.
- Obesity: being overweight or obese adds pressure on the veins in the lower rectum and anus, making haemorrhoids more likely to develop.
- Pregnancy: pregnancy often leads to increased pressure in the pelvic area and on the veins. This may cause haemorrhoids to develop in pregnant women.
- Chronic constipation and/or diarrhoea: both constipation and chronic diarrhoea strain the rectal area with added pressure. This may cause haemorrhoids to develop over time.
- Heavy lifting: regularly lifting heavy objects may contribute to developing haemorrhoids.
- Sitting/standing for prolonged periods: those who often sit or stand for long periods without breaks may be putting increased pressure on the rectal area. This may lead to the development of haemorrhoids over time.
- Genetics: a family history of haemorrhoids or weak vein walls is also a risk factor.
In Singapore, as in many other countries, haemorrhoids are typically diagnosed through a combination of medical history, physical examination, and, if necessary, additional diagnostic procedures.
Here is how haemorrhoids are commonly diagnosed in Singapore:
- Medical history: your colorectal specialist will ask you about your symptoms, including any pain, bleeding, itching, or discomfort you may be experiencing. They may also inquire about your medical history, lifestyle, and relevant risk factors.
- Physical and visual examination: a physical examination of the anal and rectal area will be performed. Your colorectal specialist may use a gloved finger to conduct a rectal examination. This involves gently inserting a lubricated finger into the rectum to feel for abnormalities, including internal haemorrhoids. They may also visually inspect the external anal area for signs of swelling, inflammation, or external haemorrhoids.
- Proctoscopy or anoscopy: in some cases, a proctoscopy or anoscopy may be performed. These procedures involve using a specialised instrument called a proctoscope or an anoscope to visually examine the inside of the rectum and the lower part of the colon. This can help identify internal haemorrhoids and other potential issues.
- Colonoscopy: if there are concerns about other gastrointestinal conditions or your colorectal specialist suspects that the bleeding may be due to something other than haemorrhoids, a colonoscopy might be recommended. This involves using a long, flexible tube with a camera to examine the entire colon and rectum.
Anoscopes are used in an anoscopy to visually examine the inside of the rectum and the lower part of the colon.
Take note that diagnostic processes vary based on individual circumstances. If you are experiencing symptoms linked to haemorrhoids, it is recommended to consult a colorectal specialist in Singapore. They can provide a proper diagnosis and recommend appropriate treatment options based on your situation.
An official diagnosis of haemorrhoids is essential for proper management and treatment; make an appointment with Alpine Surgical Practice today!
