TLDR Section:
- Piles are swollen veins in or around the anus that can cause pain, itching, or bleeding. While mild cases may improve with lifestyle changes or non-surgical treatments, recurring or severe piles often require specialist care.
- Early assessment and a personalised treatment plan can help manage symptoms effectively, reduce flare-ups, and prevent piles from returning.
Many people struggle with piles for far longer than they need to. The itching, bleeding, prolapse or discomfort may come and go. But when the symptoms keep returning, simple home remedies aren’t enough. You need a solution to eliminate piles for good.
With the right diagnosis and treatment plan, long-term relief is possible. The exact approach depends on the type of piles you have and what’s causing them. Let’s look at the different methods, including piles surgery and lifestyle changes.
What Are Piles (Haemorrhoids)?
Piles are swollen blood vessels in or around the anus and rectum. They’re common, but can be uncomfortable, itchy, or even painful.
Internal vs External Piles
Internal piles form inside the rectum, so you usually can’t see or feel them. They often present as painless bleeding during bowel movements, but larger ones may prolapse, meaning they slip out of the anus and appear as soft, moist lumps.
These may go back in on their own or need to be gently pushed back. While internal piles don’t always cause pain, they can still lead to bleeding, discomfort, mucus discharge, or a sensation of incomplete emptying.
External piles sit under the skin around the anus, where there are more pain-sensitive nerves. This is why they tend to feel tender, swollen, itchy, or irritated, especially when sitting or wiping.
If a blood clot forms inside an external pile (a thrombosed haemorrhoid), the pain can become sharp and sudden, and the lump may feel firm or bluish in colour. External piles often cause the most day-to-day discomfort because of their location and sensitivity.
Common Causes and Risk Factors
Piles form when pressure builds in the lower rectum. This may be due to:
- Straining during bowel movements
- Chronic constipation or diarrhoea
- Pregnancy
- Sitting for long periods
- Low-fibre diets
- Obesity
- Heavy lifting
Common Mistakes That Delay Lasting Relief
Many people treat piles only when they’re painful, then stop once the discomfort settles — and then the cycle starts all over again. Small oversights or delays in care often allow the symptoms to linger or come back.
Relying Only on Temporary Fixes
Topical creams, wipes, and warm baths can give short-term comfort, but they don’t fix the swollen veins driving the issue. That’s why relying on them alone usually leads to the same symptoms coming back.
Delaying Specialist Care
Many people hold off seeing a specialist, either out of embarrassment or the hope that piles will clear on their own. But delays often lead to worsening symptoms. When the problem keeps recurring, only a specialist can assess what’s truly going on and recommend a long-term plan.
If you’re experiencing recurring piles or persistent discomfort, schedule a consultation with colorectal surgeon and specialist Dr Bernard Lim in Singapore to address the problem early and take steps toward lasting relief.
Non-Surgical Treatment Options to Manage Symptoms
Not all piles require surgery. Many mild to moderate cases improve with targeted lifestyle changes or clinic-based treatments.
Lifestyle Changes
Simple habits make a big difference: add more fibre, drink more water, avoid straining, stay active, and maintain a healthy weight. These steps reduce pressure in the rectal veins and help prevent flare-ups.
Over-the-Counter Creams and Suppositories
These can calm itching or swelling during a flare-up. They’re helpful for comfort — but not a permanent fix.
Prescription Medications
Stronger topical or oral medications may be recommended if OTC options aren’t enough.
Rubber Band Ligation
A common, minimally invasive clinic procedure where a band is placed around the base of an internal pile. It cuts off the blood supply, causing it to shrink and fall off naturally.
Infrared Coagulation (IRC)
IRC uses gentle heat to shrink piles. It’s suitable for mild to moderate internal haemorrhoids
Surgical Options Remove Piles Permanently
If your piles are large, painful, or returning frequently, surgery may be the most dependable way to achieve long-term relief.
Conventional Haemorrhoidectomy
Conventional haemorrhoidectomy involves surgically removing the affected tissue and veins around the anus. It is often recommended when piles are severe, for instance, when external haemorrhoids are large, persistent, or when simpler treatments haven’t worked.
Because it removes the problematic tissue rather than just repositioning or shrinking it, this method tends to offer a long‑lasting outcome. However, recovery tends to be longer and more uncomfortable compared with less invasive alternatives.
During this procedure, a surgeon will use a circular stapling device to reposition tissue and reduce blood flow to the enlarged haemorrhoids.
This method typically avoids extensive cutting of sensitive skin around the anus, and allows patients to recover faster than with conventional surgery.
Laser Haemorrhoidoplasty
Laser haemorrhoidoplasty, also called laser hemorrhoidectomy, is a minimally invasive treatment where a surgeon uses targeted laser energy to shrink swollen haemorrhoidal tissue. The laser seals blood vessels and nerves, which helps control bleeding and speed up healing.
This treatment is often recommended for patients with moderate internal piles seeking a gentler option and quicker return to daily life. As with any procedure, suitability depends on factors like pile severity, prolapse, and overall health.
Lifestyle and Aftercare
Treating piles is only part of the journey. How you care for yourself afterwards can make all the difference in preventing flare-ups from coming back.
Diet and Hydration
Soft, well-formed stools reduce strain on the veins in your rectum. Focus on fibre-rich foods like vegetables, fruits, whole grains, and legumes. Staying well-hydrated is just as important — water helps keep stools soft and easier to pass.
Small, consistent changes to your diet and fluid intake can make a lasting impact on your comfort and recovery.
Bowel Habits and Hygiene
How you manage your bowel movements matters as much as what you eat. Avoid sitting on the toilet for long periods, and respond promptly to urges to go. Straining or delaying can increase pressure on the veins and worsen piles.
After bowel movements, clean gently with soft tissue or water to reduce irritation. Practising these habits consistently can support healing and lower the risk of future flare-ups.
When to See a Specialist for Piles
You don’t need to wait until the pain becomes unbearable to seek help. You should consult a specialist if you notice persistent bleeding, painful or swollen lumps that don’t settle, recurring flare-ups, changes in bowel habits and discomfort that affects your daily life. Sometimes the symptoms may not be due to piles or some other more serious condition like cancer
If you need personalised guidance, Dr Bernard Lim, Senior Consultant General & Colorectal Surgeon at Bernard Lim Specialist Surgery, can help. He provides comprehensive piles treatment in Singapore, prioritising minimally invasive and non-invasive options and recommending surgery only when necessary.
