Dr C.K. Leow
Liver, Pancreas, Colon and General Surgery

Haemorrhoids and You

Haemorrhoids, more commonly known as piles, is a common condition. Basically a haemorrhoid is a cushion of enlarged veins (blood vessels) situated just before the anus (opening of the back passage). During defaecation minor trauma to the surface of the piles will then lead to bleeding. Haemorrhoids can affect anyone but tend to be more common in women during pregnancy or following child birth and in individuals who have a history of constipation.


The most common symptom is one of bleeding at the end of defaecation. The blood can be on the toilet paper or could drip into the toilet bowl. The colour of the blood is normally described as bright red. The bleeding is usually not associated with pain and it stops spontaneously. Patients can experience cycles of exacerbation when their haemorrhoids are more problematic.

Haemorrhoids can be painful when they protrude out of the anus. When the haemorrhoids do not return spontaneously after defaecation, they can become uncomfortable and can be painful especially when they become thrombosed. When the haemorhhoids are prolapsed, you can feel a lump at the anus. The size of the lump varies.


After taking a complete medical history, a physical examination may not reveal any abnormalities. Examination of the area around the anus may be normal. The haemorrhoids are only visible if they have prolapsed out. A simple examination with a proctoscope (a short tubular instrucment placed into the anus) will allow the doctor to visualize the haemorrhoids.


The treatment methods for heamorrhoids include rubber band ligation, injection of the haemorrhoids and surgical removal of the haemorrhoids. Which method is being used will depend of the size and severity of the haemorrhoids.

Rubber band ligation and injection of the haemorrhoids are ‘office’ procedures and do not need anaesthetics or hospital stay. Surgical removal of the haemorrhoids will require hospitalization.


It is very important to realize that bleeding from the back passage in most patients is due to an underlying haemorrhoidal condition. However, cancer of the colon and rectum can also cause bleeding from the back passage. Hence it is crucial that this possibility is excluded by a telescopic examination before the blame for the bleeding is placed on the haemorrhoids alone. It is important for you not to put your bleeding down to a haemorrhoid and ignore the condition without first consulting a doctor. Despite treatment, haemorrhoids can recur. By ensuring a regular bowel habit with no or minimal straining, the chance of recurrence is reduced.