Haemorrhoids
Make an AppointmentHow are Haemorrhoids Diagnosed?
Diagnosis of haemorrhoids involves a combination of clinical assessment, physical examination and specialised procedures to identify the type and severity of the condition, while ruling out other gastrointestinal disorders such as anal fissures, polyps, or colorectal cancer. Early diagnosis helps guide effective management and prevent complications.
Physical Examination
External haemorrhoids are often visible around the anus and can be identified through visual inspection.
Digital Rectal Examination (DRE)
- A gloved, lubricated finger is inserted into the rectum to feel for swelling, lumps, or other abnormalities.
- This test is common in assessing internal haemorrhoids and is often performed during a routine check-up.
Anoscopy, Proctoscopy or Sigmoidoscopy
These instruments provide a detailed view of the anal canal and lower rectum, enabling the detection of internal haemorrhoids that may not be palpable during a digital examination.
Colonoscopy (If Required)
A full colonoscopy may be recommended if there is persistent rectal bleeding, a personal or family history of colorectal cancer, or suspicion of other gastrointestinal conditions.
Treatment Options for Haemorrhoids
The treatment approach depends on the type, severity, and recurrence of the condition. Options range from conservative home remedies to surgical interventions.
At-Home Remedies for Mild Cases
- High-fibre Diet and Hydration: Maintaining fibre-rich foods and staying well hydrated can help prevent straining and keep bowel movements regular. A consultation with a dietetics service can help personalise dietary strategies for optimal fibre intake and hydration.
- Topical Creams and Ointments: Over-the-counter treatments with hydrocortisone, witch hazel, or lidocaine can relieve itching and inflammation.
- Warm Sitz Baths: Soak the anal area in warm water 2–3 times daily for symptom relief.
- Oral Pain Relievers: Medications like ibuprofen, paracetamol, or aspirin may help reduce pain.
If symptoms persist beyond 7 days, consult a healthcare professional. Persistent rectal bleeding or severe discomfort should be assessed immediately.
Minimally Invasive Procedures
When symptoms don’t improve with conservative treatments, the doctor may suggest one of the following in-office procedures:
Rubber Band Ligation
- A rubber band is placed around the base of an internal haemorrhoid to cut off its blood supply.
- The haemorrhoid shrinks and falls off within a week.
- Some bleeding or discomfort may occur a few days after the procedure.
Sclerotherapy
- A chemical solution is injected into the haemorrhoid to shrink it.
- This procedure is quick and usually painless, but it may not be as effective as ligation.
Coagulation (Infrared / Laser Therapy)
- Considered a surgical procedure
- In local practice, laser therapy is normally performed under general anaesthesia.
- Uses heat or light energy to cause small internal haemorrhoids to shrivel.
- Usually causes minimal discomfort and is done without anaesthesia.
External haemorrhoid Thrombectomy
- If a blood clot forms inside an external haemorrhoid, your provider may remove it within 72 hours for immediate relief.
These techniques are typically performed by colorectal surgeons or proctologists in an outpatient setting without the need for general anaesthesia.
Surgical Procedures for Severe Haemorrhoids
If non-surgical treatments fail, or if haemorrhoids are large and recurrent, surgery may be required.
Laser haemorrhoidoplasty
- Minimally invasive alternative.
Haemorrhoidectomy
- Surgical removal of haemorrhoidal tissue.
- Often performed under spinal, general, or local anaesthesia.
- This is the most effective long-term treatment but may involve a longer recovery period and post-operative pain.
Stapled haemorrhoidopexy
- A stapling device is used to reposition and cut off the blood supply to internal haemorrhoids.
- Typically incurs less pain and faster recovery compared to traditional haemorrhoidectomy.
- However, it carries a higher risk of recurrence and rare complications like rectal prolapse or sepsis.
Ongoing Monitoring and Follow-Up
Regular follow-up ensures proper management, assessment of treatment effectiveness, and early detection of complications or recurrence.
Preparing for Your Appointment
To make the most of your consultation, it’s helpful to prepare in advance. Follow these steps:
Check for Pre-Appointment Instructions
When booking your appointment, ask if you need to avoid certain foods, medications, or perform a bowel prep before your visit.
Make a List of Key Information
- List Your Symptoms: Record all symptoms, including bowel movement frequency, consistency, and any recent changes. Even minor symptoms can provide valuable insight.
- Gather Your Medical History: Prepare details about any supplements or medications you're currently taking, family history of colorectal conditions or any previous procedures like colonoscopy or sigmoidoscopy. Bring along with you any reports or records of previous investigations
- Prepare Questions for Your Doctor: Write down any questions or concerns to ensure you get all the information you need. Common questions include:
- What’s likely causing my symptoms?
- Are my haemorrhoids internal, external, or both?
- Could this be a sign of another gastrointestinal condition?
- Which treatment options are best for my case?
- Should I consider rubber band ligation, sclerotherapy, or coagulation therapy?
- When is surgery, such as haemorrhoidectomy or stapled haemorrhoidopexy, necessary?
- Are effective home remedies available alongside treatment?
- How can I manage this condition with other health issues?
What to Expect from Your Doctor
During your visit, your doctor will ask important questions to help diagnose your condition and recommend the best course of action. Expect questions such as:
- How intense is your pain or discomfort?
- Are you seeing blood during bowel movements?
- Do your symptoms worsen after sitting or straining?
- What foods do you typically eat in a day?
- Have there been any changes in bowel habits recently?
- Do you have a family history of colon or rectal cancer?
This information will help determine whether further testing, such as an anoscopy, proctoscopy, or colonoscopy, is required.
Expert Haemorrhoid Care at SJMC
At Subang Jaya Medical Centre (SJMC), patients have access to advanced diagnostic tools and personalised treatment plans delivered by experienced gastroenterologists and colorectal surgeons. Whether you’re exploring conservative care or need specialised surgical intervention, SJMC offers evidence-based options tailored to your condition.