cancer surgery: gastric (stomach) cancer
endoscopy and gastrointestinal cancer screening
gallbladder surgery
hernia surgery
patient education index
treatment of piles (hemorrhoids)
weight reduction surgery for obesity

#10-16 Connexion Farrer Park
Medical Centre
1 Farrer Park Station Road
Singapore 217562
[getting there]
Contact Phone
Phone : +65 67330846
Fax : +65 67330849
24Hr Answering
Service :
+65 65358833
Opening Hours
Mon - Fri : 9:00am - 5:00pm
Sat : 9:00am - 1:00pm

Piles (Hemorrhoids)

What are piles?
Piles are swellings that develop in the anus. These swellings comprise dilated, engorged blood vessels. Factors which predispose to development of piles include chronic constipation and excessive straining at stools and pregnancy.
These engorged blood vessels which lie just beneath the lining tissue of the anus are easily traumatized and may bleed during bowel movements. Left untreated piles may enlarge, stretching the supporting tissues in the anus so that the piles protrude out of the anus (prolapse) during bowel movements.
What are the symptoms of piles?
  • Bleeding during bowel movements
  • Lumps protruding from the anus
  • Anal pain
  • Anal itch
What are the treatment options for piles?
Treatment for piles depends on the severity of the problem. Treatment options include:
  • Medication
  • Rubber band ligation
    This is a simple, in-office procedure where elastic bands are placed on the piles. These rubber bands cut off the circulation to the piles, causing them to shrink and fall off shortly after. The entire procedure takes about 5 10 minutes, causes minimal discomfort and little or no downtime from work/other activities. Rubber band ligation works well for small piles especially when the main symptom is bleeding.
  • Surgery
    Surgery is performed when simpler treatments are not sufficient to alleviate symptoms. Surgical options available today include:

    • Conventional Hemorrhoidectomy
      This procedure involves cutting out the enlarged, engorged piles. It is performed in an operating theatre under anaesthesia. Conventional hemorrhoidectomy may be performed as day surgery where patients are sent home on the same day after the procedure is done. The surgical wound is left open and will take about 6 weeks to heal. Although conventional hemorrhoidectomy is a time-tested procedure with proven results, the open wound does cause postoperative pain and prevents patients from returning to work for some time.
    • Stapled Hemorrhoidectomy
      The surgeon places a suture around the anal canal which is used to draw piles/hemorrhoidal tissue into a specially designed surgical stapler. When fired, the stapler cuts out hemorrhoidal tissue and simultaneously staples the cut edges together. The benefits of stapled hemorrhoidectomy include less postoperative pain, faster recover and return to work.

    • Trans-anal Hemorrhoidal Dearterialization (THD)
      THD is a relatively new procedure which has gained popularity over the past 5 years. A transanal Doppler ultrasound probe enables the surgeon to precisely locate, suture and tie off the terminal branches of the superior rectal artery which feed the engorged blood vessels in the piles/hemorrhoids. This reduces congestion and swelling in the hemorrhoidal plexus effectively controlling bleeding piles. Where prolapse (protruding piles) is a significant problem, surgeons may perform mucopexy ie. sutures are placed in such a way that prolapsed hemorrhoidal tissue is drawn back up into the anal canal.