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How are bleeding piles treated?

Gastroenterology Colorectal Surgery Health & Fitness

I started noticing that the piles I got after giving birth would bleed a little if I wiped too hard. Over the last few weeks, there were 2 occasions when I bled a lot. I want to get it checked and treated. Please advise.

DOCTOR’S ANSWER (3)
Dr Quan Wai Leong
"A specialist in Digestive Health and Advanced Endoscopy"
(4 Reviews)

Although bleeding from piles are common, not all bleeding from the anus are due to piles. Bleeding which is fresh on toilet paper or dripping suggest the source being close to the anus with piles being one of the commonest cause. Other conditions with fresh bleeding include anal fissure and rectal ulcers. Blood clots or altered blood, on the other hand, suggest a bleeding source higher up.

Regardless of the actual reason, persistent bleeding or significant bleeding requires assessment and possibly treatment. A proctoscopy examination at your family clinic may be necessary to make a firm diagnosis of piles.

Rubber band ligation can also be done at the same setting to treat your bleeding if internal piles are found. Depending on your age, a colonoscopy may also be recommended to exclude bleeding from other causes such as polyp or diverticular disease.

- Dr Quan


Dr Quan Wai Leong
MBBS, MRCP, FRCP, FAMS

Gastroenterology and Hepatology, GI Endoscopy and Liver Centre @Royal Square
101 IRRAWADDY ROAD
ROYAL SQUARE
#15 - 01 Singapore 329565

415 views 17 Dec 2018

Often, women develop a protrusion of the skin at the front edge of their anus after childbirth. This is a skin tag which formed due to the stretching of your perineum and pelvis during childbirth. The skin tag then behaves as a weight at the anus every time you pass stools. Over time, it slowly causes your hemorrhoid in the anus to be dragged downwards. Not all women with this skin tag develop hemorrhoid problems and that is why colorectal surgeons tend to ask patients not to remove the skin tags if they do not have symptomatic hemorrhoids.


If you experience some bleeding on the toilet tissue after you wipe the anus too hard, it could be due direct abrasion of the anus lining at the skin tag. It could also be due to bleeding from hemorrhoids that are being dragged downward. If the bleeding is painless and drips into the toilet, it is likely to be hemorrhoid bleeding.

It is best to see a doctor to have that assessed. Your doctor will perform an anal exam including a digital rectal exam and visualizing the hemorrhoids with an anal probe called a proctoscope. Your doctor will then be able to recommend the best treatment.

Meanwhile, you can try to manage the problem by softening your stools if the stools are hard. You can do this by taking more fruits (aim for 1 serving of fruit a day, where 1 serving is equivalent to one apple/banana), drinking sufficient water to avoid dehydration and avoiding chilli/alcohol.

It is important to note that not all cases with bleeding in the anus are due to hemorrhoids. Your doctor may recommend a colonoscopy if he/she feels there may be a risk that your bleeding is from the colon.


Dr Jit Fong Lim
MBBS (Singapore), FRCS (Glasgow), FAMS (Singapore)

Lim Jit Fong Colorectal Centre

Gleneagles Medical Centre
6 Napier Road #09-09
Singapore 258499


142 views 27 Jun 2019
Dr Paul Ang
"Family Physician with special interest in Mental Health"
(1 Reviews)

Thank you Yvonne for asking this interesting question.

It is quite common to have piles problem especially before and after delivery. But there could be other causes for the bleeding as well.

Most of the time, it would improve greatly a month after delivery.

Trying to soften your stools by taking laxatives and more fluids would help as well.

You could see a GP to have it examined to see if your piles require surgery. Most piles do not require surgery to treat. 


Dr Paul Ang
MBBS, GDFM, MRCSEd

Zenith Medical Clinic

#01-374
266C Punggol Way
Singapore 823266


494 views 7 Dec 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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