Hemorrhoids

Hemor­rhoi­ds are blood ves­sel cushions in the rec­tum that ever­yo­ne has and which are important for fine con­ti­nence. Hemor­rhoi­dal dise­a­se occurs when the­se vas­cu­lar cushions beco­me abnor­mal­ly enlar­ged and cau­se dis­com­fort. This is one of the most com­mon dise­a­ses in the anal area, but is often a taboo sub­ject due to shame. Around half of all peo­p­le over the age of 50 suf­fer from hemor­rhoi­ds. The main cau­ses are chro­nic con­s­ti­pa­ti­on with strong strai­ning during bowel move­ments, lack of exer­cise, obe­si­ty, a low-fiber diet, pregnan­cy and incre­asing age. A gene­tic pre­dis­po­si­ti­on to weak con­nec­ti­ve tis­sue also plays a role. The­re are four degrees of seve­ri­ty: Gra­de 1 shows only slight­ly enlar­ged hemor­rhoi­ds that are not visi­ble. Gra­de 2 pro­tru­des when pushing, but retracts on its own. Gra­de 3 must be pushed back manu­al­ly after pro­tru­si­on. Gra­de 4 can no lon­ger be pushed back. Typi­cal sym­ptoms are bright red blood on the stool or toi­let paper, itching and bur­ning in the anus, oozing, for­eign body sen­sa­ti­on and, in advan­ced stages, pain. Dia­gno­sis is based on a proc­to­lo­gi­cal exami­na­ti­on with inspec­tion and pal­pa­ti­on as well as a proc­to­sco­py to assess the inter­nal hemor­rhoi­ds. Tre­at­ment depends on the degree of seve­ri­ty. For mild forms, basic mea­su­res help: a high-fiber diet, suf­fi­ci­ent drin­king, exer­cise, avo­id­ance of pro­lon­ged sit­ting and hea­vy pres­sing. Oint­ments and sup­po­si­to­ries can alle­via­te sym­ptoms. For gra­de 2 and 3, scl­ero­the­ra­py, rub­ber band liga­ti­on or infrared coagu­la­ti­on can be used. In gra­de 4, sur­gi­cal rem­oval is usual­ly neces­sa­ry. It is important that blood in the stool should always be che­cked by a doc­tor to rule out more serious illnesses.