Apart from the younger set of patients and their diet and fitness lifestyle contributing to bleeding piles, it is well-known that unhealthy habits increase the risk as well.

These would include smoking and chronic constipation related to not getting enough physical activity, insufficient fibre and obesity, Dr Look said.

When haemorrhoids start causing troubling symptoms, becoming swollen, inflamed or bleed (termed haemorrhoidal disease), it can severely impair quality of life and treatment is often required.

Increased pressure on the rectal vein can also occur during pregnancy, which is why pregnant women may develop the uncomfortable condition.

Dr Look said: “Older women with multiple pregnancies are at a higher risk.”


Dr Look, who sees around 500 to 600 patients with haemorrhoids each year, said that mild cases can be managed with better toilet habits and dietary changes.

However, haemorrhoids can be serious if the bleeding is massive, frequent and goes on for too long.

Recalling a case he saw recently, Dr Look said that a 28-year-old patient had been bleeding from piles for so long that she developed severe anaemia and iron deficiency.

“She even experienced breathlessness when walking. When she was admitted to hospital, she was literally as pale as a sheet and needed urgent blood transfusions.”

The patient had her haemorrhoids removed when her condition was more stable, and has since recovered.

Dr Look said that haemorrhoids can also become an emergency condition called thrombosis, when a blood clot forms within them.

This leads to swollen and gangrenous haemorrhoids that can no longer be pushed back into the anal canal.


The doctors said that the most common symptom of piles is rectal bleeding. Usually, bleeding from haemorrhoids occurs during bowel movement, and the blood is fresh and bright red.

Others may experience swelling and downward prolapse of the haemorrhoids during bowel movement, which leads to discomfort and pain.

“(Bleeding from piles) can be in small amounts covering the stools, or staining toilet paper when wiping. It can also be in large amounts, even dramatically spurting into the toilet bowl or dripping down the legs,” Dr Look said.

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