Hemorrhoids: Information & hemorrhoid doctors

Haemorrhoids are a natural structure of the human body and, strictly speaking, not a disease. The haemorrhoidal plexus consists of a large number of blood vessels and lies above the sphincter muscle of the rectum. It supports the sphincter in holding back the bowel contents. It is only when the plexus descends and causes discomfort that the affected person suffers from hemorrhoids.

Here you will find further information and selected doctors for hemorrhoids.

Haemorrhoids: Painful dilated blood vessels

Hemorrhoids are completely normal anatomical structures in the human body. This is why patients are medically referred to as having hemorrhoidal disease when they experience discomfort in the anus and rectum.

Problems in the bowel area are still considered a taboo subject. Only very few patients seek medical advice at an early stage.

It is estimated that around 50% of the population over the age of 50 in Germany suffers from hemorrhoids. In principle, however, you are not protected from hemorrhoidal disease at any age. The number of unreported cases is very high and obviously slightly more men than women are affected.

The 4 stages of hemorrhoids

Hemorrhoids are divided into 4 stages:

1. 1st degree hemorrhoids
   The vascular dilatations are still very small. They are usually discovered by chance during a colonoscopy. There is no pain at this stage, but bleeding can occur.
2. 2nd degree hemorrhoids
   The vascular nodes are already slightly enlarged and protrude outwards when using the toilet as a result of abdominal pressure. After a bowel movement, however, they spontaneously retract back into the rectal area. In addition to bleeding, burning and itching may also occur at this stage.
3. Grade 3 hemorrhoids
   In this case, the hemorrhoids protrude outwards when pushing or spontaneously, but do not retract on their own. The hemorrhoids must be pushed back with a finger. In addition to burning and itching, there may be increased pain and a discharge of fluid. A mild form of fecal incontinence, known as "stool smearing", can also occur.
4. Grade 4 hemorrhoids
   If the hemorrhoids protrude outwards but can no longer be pushed back, they are referred to as 4th degree hemorrhoids. This often occurs as an acute event, which can be accompanied by severe pain. A lack of blood supply and thromboses (blood clots) further increase the burden for those affected.

The different stages of hemorrhoids © bilderzwerg | AdobeStock

Causes of haemorrhoidal disease

The exact causes of hemorrhoidal disease are unknown. Genetic factors appear to play an important role. Dietary factors can also contribute to symptomatic hemorrhoids.

If constipation occurs, you usually have to push harder to evacuate. This causes the haemorrhoidal vessels to fill up, which can lead to their enlargement. The mucous membrane can also shear off and protrude outwards due to the increased pressure.

Correct diagnosis is important

The diagnosis is often made on the basis of the patient's description during the anamnesis interview. The doctor's initial suspicion can then be confirmed by examining the anal region. If necessary, a rectoscopy is used.

This endoscopy of the rectal area also makes it possible to determine the exact stage of the hemorrhoids or to clarify the cause of blood in the stool. Suspected haemorrhoidal disease is always checked against bowel cancer and polyps as precursors of bowel cancer.

How are hemorrhoids treated?

The treatment depends primarily on the type of symptoms. In most cases, however, drug therapy in combination with lifestyle changes is sufficient. Surgery is always the last resort for the treatment of hemorrhoids.

The declared aim of therapy is to ensure that the stool is sufficiently soft. It must be passed without much effort, i.e. without straining. To achieve this, the patient should choose a diet rich in fiber and also ensure sufficient fluids and exercise.

Taking so-called swelling agents such as psyllium husks can also lead to softer stools and therefore less discomfort.

Creams, ointments and suppositories are often used to treat hemorrhoids. The ingredients they contain (e.g. local anaesthetics or cortisone) can reduce the sensation and therefore the discomfort. However, an actual cure is not possible.

If these conservative treatment approaches are not successful, interventional methods are available. Rubber band ligation or sclerotherapy are used particularly frequently. Doctors use these methods to reduce the blood supply to the haemorrhoid.

During ligation, a rubber band is placed over the adjacent mucous membrane, which then dies off. In sclerotherapy, a liquid is injected which has the same effect as the rubber band. However, long-term success with this method is rather rare.

The best results can be achieved with surgical therapies. This involves

• the enlarged haemorrhoids themselves (so-called haemorrhoidectomy) or
• the mucous membrane above the haemorrhoids (so-called stapler mucosectomy)

removed. The long-term success rate with these methods is 85-95%.