THERE'S a new gold standard in town for the treatment of piles that promises effectively to nip the pain in the butt - minus the uncomfortable side effects.

Short and simple: The ligasure technique takes only 15 minutes, has no after effects and can be performed as a day surgery under general anaesthetic.

The ligasure technique has no after effects and can be performed as a day surgery.

'Up till recently, most people with bad cases of piles - or haemorrhoids - would probably be treated using the stapler technique. This is a relatively painless procedure, but there are often undesirable side effects,' says Dr Ng Chin, a consultant general surgeon at Raffles Hospital.

Such side effects include a persistent urge to go to the toilet that can last for six months after stapling. What's worse, a patient who has undergone stapling may have to go for corrective post-op surgery.

'Stapling removes a ring of tissues around the anus. What that does is to effectively lift or raise the anal lining, and this could cause a narrowing of the anus in up to 20 per cent of all cases. When this happens, you may need a second operation to widen the anus,' explains Dr Ng, who was previously director of the Colorectal Surgical Service at Changi General Hospital.

The new procedure, on the other hand, takes care of the piles and is virtually free of side effects. Called ligasure haemorrhoidectomy, this method employs a sealing device that fuses blood vessels together to form a seal. The entire procedure takes only around 15 minutes to perform and is virtually bloodless.

'The ligasure device has been widely used in laparoscopic surgery and is only now being used to treat piles. With this technique, patients don't lose a single drop of blood during surgery and there are no open wounds,' says Dr Ng.

Unlike stapling, the ligasure technique has no after-effects and can be performed as a day surgery under general anaesthetic. And here is even more good news - it's even cheaper than the stapler. A ligasure costs between $4,000 and $5,000, while a stapling job usually costs about $6,000.

According to Dr Ng, piles affect as many as one in two persons in their lifetime. These range from small first-degree piles to rather troublesome prolapsed piles. Most will experience varying degrees of pain, itching and bleeding.

'Piles is still considered a pretty embarrassing condition, and so people tend to wait at least six months before they see a doctor. In some cases, the bleeding can get so bad the patient becomes anaemic,' says Dr Ng, who sees up to 50 cases each month.

He advises those with piles to come forward for treatment in the early stages to avoid possible complications. 'When the piles are small, oral medication or simple clinical procedures such as rubber banding can be performed. But if you wait till it gets bad, thrombosis or blood clotting can occur and when that happens, you're likely to experience round-the-clock pain, as well as risk of infection and blood poisoning,' explains Dr Ng.

While piles can affect anyone of either sex and any age group, the condition does generally favour people with more stressful lifestyles.

'Piles are basically varicose veins near the anus. Some people get so caught up with work in the office that they hold off answering nature's call for hours at a time - and this is not healthy,' says Dr Ng.

Additional factors include obesity, sitting for prolonged periods, and poor posture. In particular, those with a habit of reading in the toilet are more at risk.

'A lot of people like to bring a book or newspaper into the toilet to read. They would sit on the toilet bowl for 20 minutes or more. What they don't realise is that indirectly, they are straining their bowels.'

But even as surgery helps get rid of the problem, Dr Ng warns that piles can recur if the patient does not take adequate measures to prevent this.

'Surgery can only do so much. It does still come down to diet and lifestyle. A high-fibre diet will ensure that there is no constipation, which will in turn lead to less straining during bowel movements and less likelihood of piles developing,' says Dr Ng.

He adds that diet is particularly important for pregnant women, who have a higher chance of getting piles. 'Pregnant women tend to eat more. Also, the weight of the baby presses down on the pelvis and this pressure could cause the veins around the anus to swell, causing piles.'

Diet aside, drinking plenty of water and regular exercise will also help to keep the bowels regular.