Piles Treatment
in Singapore

Piles are a very common problem in Asia. Piles are an abnormal swelling of blood vessels in the anus. Sometimes, these swellings can enlarge gradually to become a big lump at the anus. At other times, these blood vessels swelling can burst and result in passage of fresh blood from the anus after defecation.

Conservative & Surgical Treatments
Conservative & Surgical Treatments
Minimal Downtime by Skilled Specialist
Minimal Downtime by Skilled Specialist
What are the
Symptoms of Piles?
  • Bleeding from the rectum
  • Lump in the anal region
  • Anal itch
  • Anal pain
What are the
Various Grades of Piles?
Piles Grade 1
GRADE I
Bleeding with no lump at the anus
Piles Grade 2
GRADE II
Lump at the anus that protrudes after passage of stool, but disappears spontaneously later
Piles Grade 3
GRADE III
Lump at the anus that protrudes after passage of stool, but disappears after being pushed back into the anus
Piles Grade 4
GRADE IV
Permanent lump at the anus
Piles Treatment Options
What are the
Piles Treatment Options?
  • Medications
  • Rubberband Ligation
  • Injection Sclerotherapy
  • Traditional Surgery (Haemorrhoidectomy)
  • THD (Transanal Haemorrhoidal Dearterisation)
  • Stapled Haemorrhoidectomy
THD (Transanal Haemorrhoidal Dearterisation)

Many modalities have been used in the treatment of first- and second-degree piles, including medications, rubber ligation and sclerotherapy. Surgical excision is performed if non-surgical options failed to address the problem. A newer technique of Transanal Haemorrhoidal Dearterisation (THD) has gained popularity in the treatment of early stages of piles over the past 5 years. This technique involved the ligation of the distal branches of the superior rectal artery and thus drastically reducing blood supply to the haemorrhoidal plexus. This in turn reduces the haemorrhoidal congestion with the result of decrease haemorrhoidal bleeding and prolapse. The use of a transanal vascular Doppler allows precise ligation of the haemorrhoidal vessels at or above the level of the anorectal junction. Unlike rubberband ligation of piles, this procedure does not produce the distressing sensation of tenesmus. It is relatively painless procedure as the ligation of vessel is proximal to the dentate line and transitional epithelium of the anal canal. A haemorrhoidopexy can also be performed if there is a small component of hemorrhoidal prolapse. Many studies have shown that THD is a very effective procedure for the treatment of first- and second-degree piles. THD is less effective for third degree piles, especially if the predominant symptom is prolapsed and not bleeding. However, THD can still be offered to patients with third degree piles and refused excisional haemorrhoidectomy.

References
KH Ng et al. The Forth Branch of the Superior Rectal Artery and its Significance in Transanal Haemorrhoidal Dearterisation (THD). Techniques in Coloproctology 2010 Dec;14(4):345-8.
Dr Ng Kheng Hong
Dr Ng Kheng Hong
Senior Consultant Colorectal & General Surgeon
MBBS (Singapore), MMed (Surgery), FRCS (Edinburgh),
FAMS (General Surgery)
Dr Ng Kheng Hong has over 20 years of experience in piles treatment, including conservative methods and piles surgery in Singapore. A former Director of Minimally Invasive Surgery at the Department of Colorectal Surgery at SGH and former Visiting Consultant in Surgical Oncology at the National Cancer Centre, Dr Ng is deeply committed to his work. Dr Ng is also well-published in medical journals and continues to teach medical students to this day.
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