Singapore, Piles Capital of the World?
One in three persons in Singapore suffers from haemorrhoids, commonly known as piles. Piles refer to the enlarged and bulging blood vessels in the anus. Symptoms include rectal bleeding, anal discomfort and pain, as well as swelling. There can also be anal skin tags and fissures.
Who can get it?
Piles are actually present in all people. The normal function of these “cushioned” blood vessels is to help with liquid and gas continence. We only notice them when there is bleeding, pain, prolapse or discharge.
“In Singapore, a lot of us have been taught to exert force when we go to the bathroom. So piles are a very common problem here. My colleagues and I like to say in jest that Singapore is the piles capital of the world,” says Dr Kam Ming Hian, consultant at the Department of Colorectal Surgery, Singapore General Hospital.
Piles are more common after the age of 30. In particular, about half of the people aged over 50 exhibit piles symptoms. Pregnant women have a higher incidence of piles because there is excessive pressure on the anal region due to increased foetal weight and the tendency to strain during bowel movement.
Lifestyle can be a factor too. Persons leading sedentary lifestyles or those with bad stool habits --such as reading newspapers in the toilet-- are more prone to piles. Persons suffering from irregular bowel habits such as constipation or diarrhoea might also be at a higher risk.
Haemorrhoids: an internal or external condition
Internal piles develop within the anus. The most common symptom is bright red blood covering the stools. Although bleeding is painless, internal piles can become irritated and painful when they protrude out of the anus.
External piles occur near the anus and are covered by very sensitive skin. Symptoms include painful swelling or a hard lump around the anus after a blood clot forms.
Treatment methods
Non-surgical cures
“Stool softeners and fibre supplements may be recommended to ease bowel movement, while venotonic agents serve to reduce congestion in the piles,” shares Dr Kam.
It is also important that patients drink sufficient fluids to remain hydrated.
To soothe pain, creams, ointments and cold packs can be used. A sitz bath, where one’s anus and buttocks are temporarily submerged in saltwater, can not only provide soothing relief but also reduce swelling in prolapsed piles.
Surgery
“In cases where the above treatments don’t work, we can consider rubber band ligation. Applied just above the haemorrhoids, these elastic rings serve to cut off the blood supply and cause the piles to drop off,” says Dr Kam.
He adds, “In more severe cases, the haemorrhoids have to be surgically removed. The latest technique is stapled haemorrhoidectomy, where a specialised stapler is used instead of laser excision.”
Prevention tips
To avoid piles, follow these three prevention tips:
- Increase your fibre and fluid intake;
- Avoid straining at stool;
- Exercise regularly.
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