Haemorrhoids are also known as piles. Although they can be unpleasant and painful, they can be easily treated and are very preventable.

Hemorrhoids can occur both internally inside the anus and externally, under the skin of the anus.

Haemorrhoids are most common among adults aged 45-65. However, this does not mean that young people and children do not get them.

Women often develop them during pregnancy.



When blood vessels within the anal cushions in the rectum are dilated or engorged with blood, they swell and enlarge, becoming what are known as haemorrhoids.

They occur due to the following reasons:

  • Aging
  • Pregnancy
  • Chronic diarrhea
  • Chronic constipation – from straining to defecate
  • Sitting for long periods on the toilet bowl
  • Obesity
  • Genetics – some people inherit a tendency to develop haemorrhoids

Internal haemorrhoids, which lie inside the rectum may cause painless rectal bleeding or prolapse.

External haemorrhoids will lie under the skin around the anus. They can become very itchy and may bleed. Sometimes, blood may accumulate and form a thrombus (clot), which can be painful. The area will be swollen and inflamed.





Symptoms of haemorrhoids include:

  • Bleeding, usually painless
  • Itching or irritation in the anal area
  • Discomfort and pain in the anal region
  • Lumps protruding out through the anus
  • A lump near your anus, which can sometimes be sensitive
  • Seepage of mucus


Rubber Band Ligation
A rubber band is placed around the base of the haemorrhoid inside the anal canal. The band cuts off blood supply to the haemorrhoid which then shrivels and falls off in 3-4 days.

Injection Sclerotherapy
The surgeon passes a short instrument into the anal canal and injects an oily solution into the top of the haemorrhoid. This causes inflammation at the base of the haemorrhoid, resulting in scarring, thereby reducing the size of the haemorrhoid.

Transanal Haemorrhoidal Dearterialization
This is a form of surgery that does not involve removal of haemorrhoidal tissue. The surgeon identifies the blood vessels supplying the haemorrhoids with a doppler ultrasound, and sutures the supplying blood vessels. This causes the haemorrhoids to shrink.

An incision is made to remove the haemorrhoids. This is performed using a scalpel, scissors, or electrocautery. The wounds may be left open to granulate over or sutured closed.

Stapled Haemorrhoidectomy
A circular stapling device is used to remove a ring of excess haemorrhoidal tissue. This disrupts the blood supply and also hitches the cushions back to their normal position within the anal canal.