Why Do My Haemorrhoids Keep Returning?

What Are Haemorrhoids (Piles)?

Haemorrhoids are enlarged, swollen blood vessels located in the lower rectum and anus. While everyone has haemorrhoidal tissue as part of normal anatomy, issues arise when these tissues become inflamed, swollen, or displaced.

Common symptoms include:

• Bleeding during bowel movements (often the first sign)
• Itching or irritation around the anus
• Pain or swelling
• A sensation of incomplete bowel evacuation

Many people initially attribute these symptoms to minor lifestyle factors or temporary digestive issues, which can delay treatment and increase the risk of recurrence.

Common Causes of Haemorrhoid Recurrence

The primary reason for recurrence is that underlying risk factors often remain unchanged after initial treatment, thereby creating the same conditions that initially caused the problem. Common causes include:

• Straining During Bowel Movements

  Frequent straining increases pressure on the rectal blood vessels, which can contribute to the return of haemorrhoids. Spending long periods on the toilet, particularly while distracted by phones or other devices, can disrupt natural bowel rhythms and make straining more likely.

• Chronic Constipation or Diarrhoea

  Constipation and diarrhoea are key factors in the recurrence of haemorrhoids. Constipation causes strained bowel movements and hard stools, which directly irritate haemorrhoidal tissue. Conversely, diarrhoea leads to repeated irritation and inflammation. The frequent consumption of coffee and tea without adequate water intake also contributes to dehydration, which in turn can lead to constipation.

• Sedentary Lifestyle

  In Singapore, many people spend long hours sitting at work, during commutes or at home. Prolonged sitting reduces blood circulation and increases pressure in the pelvic veins, creating conditions that make haemorrhoids more likely to develop and recur.

• Obesity

  Excess weight increases abdominal pressure, which is a major contributing factor to haemorrhoids. In Singapore, rising obesity rates—partly attributed to frequent dining out and inactive lifestyles—have contributed to an increase in haemorrhoid prevalence.

• Pregnancy

  Pregnancy can make haemorrhoids more likely due to hormonal changes, increased blood volume, and the pressure exerted by the growing foetus. These factors can also contribute to recurrence after treatment.

• Incomplete Haemorrhoid Removal After Surgery

  Sometimes, piles surgery may not address all existing tissue, especially when multiple haemorrhoids are present. Additionally, if lifestyle habits aren’t adjusted after the procedure, new haemorrhoids can develop in previously healthy areas.

What Are the Treatment Options for Haemorrhoids in Singapore?

For recurring haemorrhoids, over-the-counter ointments, creams, and suppositories can help relieve symptoms, but they do not address the underlying cause. Doctors typically recommend starting with key lifestyle adjustments to break the cycle, such as avoiding prolonged sitting and straining on the toilet, increasing fluid and fibre intake, maintaining a healthy weight, and staying physically active.

When lifestyle changes alone are not enough, your doctor may suggest one of several medical or surgical treatment options:

• Rubber-Band Ligation: TConsidered the gold standard for Grade II and III internal haemorrhoids, this procedure involves placing rubber bands around the base of the haemorrhoid to cut off its blood supply. It is a highly effective treatment with low recurrence rates when combined with lifestyle modifications.
• Conventional Hemorrhoidectomy: This is a complete surgical removal of hemorrhoidal tissue, typically reserved for severe Grade III and IV haemorrhoids. While highly effective, it has a longer recovery time.
• Stapled Hemorrhoidectomy: A less invasive surgical option that repositions hemorrhoidal tissue using surgical staples. This technique offers a shorter recovery time.
• Transanal Hemorrhoidal Dearterialisation (THD): An advanced technique that uses Doppler guidance to identify and cut off the blood supply to hemorrhoidal tissue. It offers excellent results with minimal post-operative discomfort

How to Prevent Haemorrhoids From Returning After Surgery

To prevent haemorrhoids from returning after surgery, a combination of consistent lifestyle changes and medical guidance is key. If you suspect your haemorrhoids have returned or if symptoms persist, it is important to consult a colorectal specialist. Our piles surgeon in Singapore, Dr Kam Ming Hian, helps patients identify the specific factors contributing to their recurrence and develop personalised strategies to reduce risk.

Contact our clinic at enquiry@kamcolorectal.com to arrange a consultation. We can assess your condition, determine the most appropriate treatment option, and provide a detailed cost estimate.