Haemorrhoid Management
What are Haemorrhoids?
Haemorrhoids, also known as piles, are enlarged blood vessels found inside the anus and rectum. They can cause bleeding, itchiness, prolapse during straining, pain and discomfort during bowel motions. Haemorrhoids can be either internal or external.
Terminology:
Internal Haemorrhoids are inside the back passage (anal canal) where the rectum joins the anus. They may be aggravated by constipation and straining. When internal haemorrhoids enlarge, it may bleed during the bowel motions. When it progresses, may prolapse down and protrude out during bowel motions.
External Haemorrhoids are outside the back passage and covered by skin. They may occur during childbirth or straining as the anal skin is stretched. External haemorrhoids can often cause irritation, itchiness and if a clot forms in a blood vessel, they may even become painful. This may be part of the internal haemorrhoids.
Skin Tags, or other flaps of skin, may present around the outside of the anus. These are remnants of swollen skin that are more a nuisance than a health concern. They do not bleed, but may itch.
How do I manage my haemorrhoids?
During your clinic visit, your surgeon will discuss the management option that suits you best. Dr Ruwan Perera provides skilled management involving the following treatment methods:
Before the treatment, depending on the age and risk of bowel cancer, Dr Perera needed exclude risk of other pathology by performing a sigmoidoscopy or colonoscopy. Bleeding may be due to a polyp, fissure, inflammation, or lesion in the large bowel.
Rubber Band Ligation: is used widely to effectively treat large internal haemorrhoids that bleed and prolapse. The procedure can be performed during a colonoscopy under sedation and does not require anaesthesia. It involves placing small rubber bands around the neck of the haemorrhoids. These bands will reduce the blood supply to the haemorrhoids, resulting in the haemorrhoids decreasing in size.
The procedure is generally painless and you can be discharged on the same day.
Haemorrhoidal Artery Ligation: is designed to remove haemorrhoids without the need for cutting and in some cases without the need for general anaesthesia. It involves using a Doppler transducer to locate arterial blood vessels supplying the haemorrhoids. These blood vessels will then be tied off using small stitches, which cut off the blood supply to the haemorrhoids. In the few days following the procedure, the haemorrhoids will reduce in size.
Haemorrhoidectomy involves the removal of the internal/external haemorrhoids and associated skin. It is used for large prolapsing internal/external/thrombosed haemorrhoids. The procedure is performed under general anaesthesia and you will need to stay in the hospital for a few days.
Stapled Haemorrhoidectomy This procedure is effective for internal haemorrhoids. Any abnormally large haemorrhoid tissue is removed. Following this, the remaining haemorrhoid tissue is stapled back to its normal anatomical position.
How do I prepare for the procedure?
Post-Operative Care
- Dr Perera will discuss pain management following haemorrhoidectomy with you during the consultation visit and prior to your discharge from the hospital.
- A warm sitz bath can be purchased from your local chemist and used to alleviate any discomfort in the perineum.
- You are advised to take a high-fibre diet with adequate amounts of water to avoid constipation and ensure soft bowel motions.