If dietary changes and medication don't improve your symptoms, consider coming for consultation. Dr Ng
can confirm whether you have haemorrhoids and recommend appropriate treatment.
If you have internal haemorrhoids (grade 1 and 2) in the upper part of your anal canal, non-surgical
procedures such as banding and sclerotherapy may be recommended.
Banding
Banding involves placing a very tight elastic band around the base of your haemorrhoids to cut off their
blood supply. The haemorrhoids should then fall off within about a week of having the treatment.
Banding is usually a day procedure that doesn't need an anaesthetic, and most people can get back to
their normal activities the next day. You may feel some pain or discomfort for a day or so afterwards.
Normal painkillers are usually adequate, but something stronger can be prescribed that your haemorrhoids
have fallen off, as they should pass out of your body when you go to the toilet. If you notice some
mucus discharge within a week of the procedure, it usually means that the haemorrhoids have fallen off.
Directly after the procedure, you may notice blood on the toilet paper after going to the toilet. This
is normal, but there shouldn't be a lot of bleeding. If you pass a lot of bright red blood or blood
clots (solid lumps of blood), go to your nearest accident and emergency (A&E) department immediately.
Ulcers (open sores) can occur at the site of the banding, although these usually heal without needing
further treatment.
Electrotherapy (Haemorrhoid Energy Therapy)
Electrotherapy, also known as electrocoagulation, is another alternative to banding for people with
smaller haemorrhoids. This is a relatively new treatment that only became available in Singapore from
2016.
During the procedure, a specially designed proctoscope is inserted into the anus to locate the
haemorrhoid. An electric current is then passed through the base of the haemorrhoid, heating it up to 55
degrees Celcius.
The aim of electrotherapy is to cause the blood supplying the haemorrhoid to coagulate (thicken), which
causes the haemorrhoid to shrink. If necessary, more than one haemorrhoid can be treated during each
session.
Electrotherapy is usually carried out as a short day case procedure under gentle sedation.
Usually there is no pain at all after the procedure is completed. You may experience rectal bleeding
after the procedure, but this is usually short-lived.
Electrotherapy has been shown to be an effective method of treating smaller haemorrhoids. It can also be
used as an alternative to surgery for treating larger haemorrhoids, but there's less evidence of its
effectiveness.
For Dr Ng, this procedure has almost completely replaced rubber band treatment as it typically causes no
pain or discomfort and more areas can be treated at the same time leading to greater efficacy.