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Piles Ligation

What are Piles or Haemorrhoids?

Piles, or haemorrhoids, are essentially veins within the anus that can cause anal pain, swelling, and bleeding. Mild cases of piles can be managed with home remedies, such as eating high-fibre foods, engaging in regular exercise, soaking in sitz baths, applying ice packs to reduce swelling, and maintaining good hygiene in the anal area. Additionally, your doctor might prescribe oral medication or topical treatments such as ointments or suppositories, to alleviate discomfort. However, if the piles continue to cause significant issues, more advanced treatment options may be necessary.

PROCEDURE For PILES LIGATION

Rubber band pile ligation or bipolar coagulation (HET™), is typically performed after a colonoscopy or sigmoidoscopy examination. The entire procedure usually takes 30-45 minutes. For small to medium-sized piles, minimally invasive treatments like rubber band ligation or coagulation therapy can be applied.

  • Rubber Band Ligation: This is the most common method used. Small rubber bands are placed around the base of the internal piles to cut off the blood supply. As a result, the piles shrink and eventually fall off over the next several days.
  • Bipolar Coagulation (HET™): In this procedure, bipolar energy is applied to the internal piles to coagulate blood, causing the piles to shrink.

Both treatments are usually done on an outpatient basis, and most patients experience only mild discomfort and can return to work shortly afterward.

WHEN Should I Get A PILES LIGATION or Bipolar Coagulation (HET™)

You should consider piles ligation or Bipolar Coagulation (HET™) if

  1. Recurrent piles bleeding despite medical therapy
  2. Piles swelling
  3. Anal pain due to thrombosed piles

PREPARING FOR THE PILES LIGATION or Bipolar Coagulation (HET™)

Preparation for piles ligation or bipolar coagulation is similar to preparing for a colonoscopy. You will need to fast for at least six hours before the procedure. Clear fluids may be consumed up to two hours before the treatment. Medication to clear your bowels (bowel preparation) will be provided, and it’s important to follow the instructions carefully. In most cases, medications can be continued, except for diabetic medications and blood thinners. Be sure to consult your doctor about any necessary adjustments for your medication. Sedation will be provided, so you must arrange for someone to take you home after the procedure, as driving or making important decisions is not advised for the rest of the day.

BEFORE THE PILES LIGATION or Bipolar Coagulation (HET™)

A nurse will carry out a pre-procedure check and then bring you to the procedure room where an intravenous line will be inserted.

DURING The PILES LIGATION or Bipolar Coagulation (HET™)

You will be positioned on your left side, and sedation will be administered. Once you are asleep, the procedure will begin. Since you will be under sedation, you may not remember any part of the procedure. You will be closely monitored throughout, and once the procedure is complete, you will gradually wake up.

AFTER The PILES LIGATION or Bipolar Coagulation (HET™)

Following the procedure, you will be moved to a recovery area where you will be monitored as you regain consciousness from the anaesthesia. Mild abdominal discomfort or bloating may occur but typically resolves within 24 hours. After the post-procedure assessments, the nurses will offer food and drinks. You should arrange for a family member or friend to take you home. It is recommended to rest for the remainder of the day, and return to work or resume driving the following day. Your doctor will schedule an appointment to review the procedure and any necessary follow-up.

Recovery and Post-Treatment Care

After your piles treatment procedure in Singapore, it’s essential to follow proper aftercare to ensure a smooth recovery. While the majority of patients experience only mild discomfort, it’s important to avoid heavy lifting or straining during bowel movements for a few days following the procedure. Regular follow-up appointments with your doctor are crucial to monitor healing and address any concerns. Your specialist may recommend certain lifestyle changes, such as a high-fibre diet, to reduce the risk of recurrence. If you experience any unusual symptoms, such as excessive bleeding or persistent pain, it’s vital to consult your clinic immediately for further evaluation. Cost for follow-up care will depend on the clinic and treatment plan, so it would be best to consult your doctor for more information.

SAFETY Of The PILES LIGATION

Piles ligation and HET™ treatment are generally very safe. The most common side effects are anal pain and bleeding, which occur in 10-20% of patients. These issues are expected, given the nature of the procedure, which involves the removal of blood vessels in the anal cushion. Serious complications are rare, occurring in about 0.1% of cases, and typically result from disease factors. Rare complications may include colon wall tearing, bleeding, or adverse reactions to anaesthesia. Your doctor will inform you about potential complications and provide guidance on how to handle any issues that may arise.

QUALITY Of The PILES LIGATION

Most patients require up to 2-3 times piles treatment to achieve the best result. You may discuss with your specialist should you have recurrent symptoms.

COST Of The PILES LIGATION

Piles ligation is classified as a hospital procedure, and its cost is typically covered by most hospitalisation plans. It is also Medisave deductible. Many private health insurance plans, including corporate health benefits, offer coverage for the procedure. The Ministry of Health provides fee benchmarks, which are published for transparency across hospitals. Prior to any endoscopic procedure, financial counselling is provided to help patients understand the cost breakdown. It’s important to check with your insurance provider and carry out independent research before seeing a doctor or specialist for piles treatment in Singapore.