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Piles Surgery Singapore - Haemorrhoids Treatment
Piles (or haemorrhoids) are very common in Singapore. They are characterised by pain and a sensation of a lump in the anal region, as well as bleeding during bowel movements.
Piles are enlarged blood vessels found within the inner lining of the rectum or the surface of the anus. Some may be located within the anal canal, while some may protrude outside of it.
Typically, these blood vessels do not cause any issue. However, with repeated and/or excessive pressure (e.g. chronic constipation, childbirth), the blood vessels may swell and become inflamed. And as the wall of the blood vessels stretch, they may break upon pressure, resulting in bleeding.
Dr Chew is an experienced piles surgeon who has been involved in various research studies evaluating the effectiveness and safety of various haemorrhoid surgical procedures.


Common symptoms of piles include pain and itching in the anal area, blood on the toilet paper or in the toilet bowl after a bowel movement, a sensation of a lump near the anus, as well as mucus discharge from the anus.


To diagnose haemorrhoids, a doctor will first conduct a physical examination. This typically involves a visual inspection of the anus and surrounding area. If internal haemorrhoids are suspected, they may perform a digital rectal exam, in which the doctor will gently insert a lubricated and gloved finger into the rectum to feel for the presence of haemorrhoids. In a few cases, an additional test called a sigmoidoscopy or colonoscopy might be recommended to rule out other serious causes of bleeding, such as colorectal polyps or cancer.


  • Internal Piles: These piles develop within the rectum and usually does not cause any pain or discomfort. However, some may protrude from the anal canal upon straining. In mild cases, the piles can be manually pushed back in; in more serious cases, the protruding piles are unable to be pushed back into the anal canal.
  • External Piles: External piles develop around the anus, and is characterised by a lump near or around the anus. They may cause pain, itching and bleeding; and are not reducible. External piles are at risk of developing sudden and painful blood clots (thrombosis).
  • Thrombosed Piles: Thrombosed piles are piles that are filled with blood clots. They present with severe symptoms such as intense pain, burning, itching and swelling. They must be quickly treated to prevent the loss of blood supply and tissue damage.

If you notice signs and symptoms of piles, make an appointment with our doctor at 6518 4688 or WhatsApp us to receive an accurate diagnosis.


Haemorrhoids treatment vary depending on the type and severity of the piles. Piles or haemorrhoid surgery will only be needed in more advanced cases; and your surgeon will be in the best position to determine the type of piles treatment you need.


  • This centres around reducing constipation and symptomatic relief. You may be recommended to increase your fibre intake (not excessively) or take laxatives in order to soften your stools. You may also try sitting in a warm sitz bath to help relax the anal muscles, provide pain relief and improve blood flow. Topical creams or oral medication may also be used to temporarily ease inflammation and itching and other symptoms.


  • Should the above conservative methods not work, your piles surgeon may recommend minimally invasive treatments such as rubber band ligation.

  • In the first method, a rubber band will be placed around the base of the piles, restricting its blood supply and causing it wither and die off within a few days.


In cases where the above conservative and minimally invasive methods prove insufficient, piles surgery (haemorrhoidectomy) may then be recommended. This can be mainly done through the conventional, stapled method or via a new method known as laser haemorrhoidectomy.

  • Conventional Haemorrhoidectomy

    In the conventional method, this method has been used for many years and is an effective method will excision of the piles and skin tags. This method of piles surgery is suitable in many type of piles and is still commonly performed.

  • Stapled Haemorrhoidectomy

    In the stapled method, the piles are removed through a circular stapling device without the need for an incision. Piles excised in this fashion have been reported to have less post operative pain. Speak to us to find out if you are suitable for this.

  • Transanal Haemorrhoidal Dearterialisation

    Transanal Haemorrhoidal Dearterialisation (THD) is a minimally invasive procedure that involves locating the arteries that supply blood to the haemorrhoids using a Doppler ultrasound probe. Once located, the surgeon ties off these arteries, thus stopping the blood flow to the haemorrhoids, causing them to shrink and eventually disappear.

  • LigsaSure Haemorrhoidectomy

    This is a type of haemorrhoid surgery that uses advanced technology to remove haemorrhoids. In this procedure, a special device is used to apply precise amounts of heat to seal off the blood vessels supplying the haemorrhoids.

  • Laser Haemorrhoidoplasty

    In one of the newest methods, laser haemorrhoidectomy has been performed by our piles surgeon. This method requires a small incision and insertion of a laser probe inserted into the pile. The initial results suggest equivalent short term outcomes but with less post operative discomfort.

For effective and targeted piles treatment, make an appointment with us at 6518 4688 or WhatsApp us for more information on the options available.


Haemorrhoid surgery, like any medical procedure, comes with certain risks that one should be aware of. This includes temporary pain and bleeding, infection, anal stricture, recurrence of haemorrhoids, or faecal incontinence caused by damage to the anal sphincter muscles.

However, in experienced hands, the risk of complications are rare. Most people recover smoothly, especially when they follow proper postoperative care instructions.


After haemorrhoid surgery, post-operative care is key to ensuring a smooth and speedy recovery. This includes:

  • Pain Management: You will be given medications to alleviate the pain. You may also be given stool softeners to ensure that you do not develop hard stools, which is painful and can also hinder healing.
  • Hygiene: Keeping the anal area clean is key to preventing infection. You may be advised to take a warm sitz bath, especially after bowel movements. This can help soothe the area and keep it clean.
  • Activity: While rest is important, gentle activities such as short walks can promote blood circulation and speed up recovery. However, avoid heavy lifting and strenuous exercise until your doctor clears you to do so.
  • Follow-up Checks: Attend all follow-up appointments so that your doctor can monitor your healing and address any concerns you may have.
  • Lifestyle Changes: To prevent the recurrence of haemorrhoids, you should maintain a balanced, high-fiber diet, stay hydrated, get regular exercise, and avoid long periods of sitting.
FAQs on Haemorrhoids (Piles)
  • Chew MH; Tan WS; Eu KW
    The use of CEEA 34 in stapled hemorrhoidectomy: suggested modifications in technique.
    World journal of surgery 2008; 32(6):1160-1111 (Article; Published in Print)
  • Ng KH; Chew MH; Eu KW
    Modified stapled haemorrhoidectomy: a suggested improved technique.
    ANZ journal of surgery 2008; 78(5):394-377
  • Chew MH; Chiow A; Tang CL
    Keloid formation after stapled haemorrhoidectomy causing anal stenosis: a rare complication.
    Techniques in coloproctology 2008; 12(4):351-322 (Letter; Published in Print)
  • Chew MH; Kam MH; Lim JF; Ho KS; Ooi BS; Tang CL; Eu KW
    The evaluation of CEEA 34 for stapled hemorrhoidectomy: results of a prospective clinical trial and patient satisfaction.
    American journal of surgery 2009; 197(6):695-701 (Article; Published in Print)
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