By: 
Do you tend to strain on the toilet bowl, and occasionally experience bleeding during bowel movements? You might have haemorrhoids or piles, a condition characterised by discomfort around your anus due to swollen blood vessels around the area.
Having piles may be embarrassing, but the earlier you seek haemorrhoid care, the better.
At the doctor’s, you will be asked about your health history as well as your symptoms. These together with the following tests will determine whether you require surgery:
In the event you require surgery, your doctor will advise accordingly. Continue reading to learn about piles treatment, the cost of haemorrhoid surgery, and the available subsidies.
Hemorrhoids or piles are swollen blood vessels in the anus caused by increased pressure in the lower rectum due to:
Hemorrhoids can be classified as internal or external depending on where it begins.
External hemorrhoids form on the anus’s outer surface. Typically, they cause a painful swelling when a blood clot forms inside.
External piles have a hard, sensitive lump-like feel to them. Bleeding only happens when the skin beneath ruptures.
Internal hemorrhoids begin at the upper part of the anal canal. Like external hemorrhoids, internal hemorrhoids are a result of repetitive straining. However, with internal hemorrhoids, not only is the blood vessel wall stretched and thinned but its supporting ligaments are damaged as well.
When this happens, the blood vessel descends the anal canal and protrudes outside the anus. This is known as a prolapsed hemorrhoid.
To diagnose internal hemorrhoids or rule out other conditions, your doctor may conduct the following tests:
In most cases, piles symptoms are minor and remediate on their own. Patients need to be aware of the following symptoms:
Hemorrhoids and piles are rarely dangerous, but it is critical to consult a physician if symptoms persist, particularly if they span over a week.
Even though they usually resolve independently, treatment is required if there is blood or the discomfort becomes intolerably severe.
Although hemorrhoids can affect anyone, they tend to be more prominent in the following groups:
Your condition’s severity and type will determine the hemorrhoids or piles treatment you receive. Medication, dietary changes, a local procedure such as rubber-band ligation or HET, and surgery are all common methods. Your doctor will give you advice regarding the best approach.
Dietary changes and medication may be sufficient. Some people believe that avoiding spicy or fast foods will make piles disappear. These are myths that lack solid scientific evidence. However, some lifestyle changes may be beneficial, such as:
Using local treatment options like rubber-band ligation or HET might be necessary.
Ligation of piles can be done in the clinic as an outpatient procedure without requiring anaesthesia. In this procedure, the blood supply to the piles is stopped by placing a tiny rubber band at their base.
Within 3 to 5 days, the piles will shrivel, die and fall off during regular bowel movements. The shedding of the shrivelled piles is typically invisible to the patient, though some mild bleeding during faeces in the first week may happen. Prolapse and bleeding will be stopped by the scarring that develops.
This involves injecting a substance into a haemorrhoid to cause it to shrink over several weeks.
This involves applying a mild electric current to your piles to reduce their size.
This uses infrared light to diminish hemorrhoids by cutting off the blood supply.
Surgery might be necessary to treat the piles at this stage, particularly if they prolapse out of the anus and can’t be pushed back in. Stapler hemorrhoidectomy, Conventional hemorrhoidectomy, and Transanal Hemorrhoidal Dearterialization(THD) are examples of surgical procedures.
In a hemorrhoidectomy, the piles are cut off or excised. This procedure is done with a variety of instruments. A great deal of care is taken to prevent bleeding and minimise tissue removal. Typically, the wound is left open to recover fully.
Hemorrhoids are pulled back into the anus with the aid of a special stapler, and their blood supply is decreased.
The hemorrhoids’ size will gradually decrease after their blood supply is reduced. Except in cases where anal skin tags are removed concurrently, the surgical wound is contained within the rectum, and there is no external wound.
In THD, the anus is surgically opened up with a specialised tool. The blood vessels supplying the hemorrhoids are located using an ultrasound probe and then tied off. If there is a lot of tissue, it may be stitched together, pulling the hemorrhoids back into the anal canal.
The cost will vary patient to patient, depending on:
Public Hospitals/Centres (Subsidised)
| Ward B2 | Ward C | Day Surgery | |
|---|---|---|---|
| Operation Fee | $ 488 | $ 314 | $ 518 |
| Other Fees | $ 570 | $ 603 | $ 344 |
| Total | $ 1,115 | $ 986 | $ 896 |
Public Hospitals/Centres (Unsubsidised)
| Ward A | Ward B1 | Day Surgery | |
|---|---|---|---|
| Operation Fee | $ 1,893 | $ 1,968 | $ 2,167 |
| Other Fees | $ 1,629 | $ 1,432 | $ 856 |
| Total | $ 3,556 | $ 3,307 | $ 3,034 |
Private Hospitals/Clinics
| Surgeon Fee | $2,650 - $3,400 |
|---|---|
| Anaesthetist Fee | $635 - $900 |
*These figures are based off MOH’s Historical Transacted Bill Sizes and Fee Benchmarks.
The total pile removal surgery cost in Singapore may include hospitalisation fees and reimbursements from your insurance.
Speak with your insurer to learn more about your funding options and out-of-pocket expenses.
Singapore residents who have piles surgery may be eligible for MediSave reimbursement. This is, however, subject to the CPF Board’s maximum claimable amount.
Singaporeans can supplement Medishield Life’s private healthcare coverage with additional coverage through the Integrated Shield Plan. If your plan includes co-insurance and the deductible cost, you might qualify for cashless procedure eligibility.
Cashless procedure eligibility is a zero out-of-pocket payment option for your treatment and hospital stay. Your eligibility varies according to CPF Claimables, Insurance Policy, Medisave eligibility, and the procedure’s Table Code.
Piles rarely pose a long-term health risk and can be self-managed. Surgery is typically an outpatient procedure for more severe piles with a quick recovery.
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