Haemorrhoids are blood vessels which form a type of padding on the anus. Everybody has this vascular padding. Haemorrhoids in the sense of a disease or haemorrhoidal disease occur the haemorrhoids are enlarged and cause problems. This can result in itching, pain and bleeding.

Haemorrhoids form arteriovenous blood vessel padding on the rectum and are important for the closing function of the anus. However, the term haemorrhoids is often used as a synonym for actual haemorrhoidal disease, in which haemorrhoids are enlarged. Haemorrhoids which cause problems are divided into four stages. In Stage I, the haemorrhoids are enlarged, but yet not visible or palpable. From Stage II, the haemorrhoids protrude into the rectum when the patient strains; however, they retract autonomously. In Stage III, the haemorrhoids can only be pushed back with external pressure, and in Stage IV not at all.

There are different risk factors which can lead to problems with haemorrhoids. They include chronic constipation, overstraining during bowel movements and excessive weight. Sometimes problems with haemorrhoids also appear during pregnancy or after a birth.

Typical symptoms of haemorrhoids are itching on the anus, pain during bowel movements and smear of blood on the toilet paper. Any blood which is present in the stool should be checked immediately by a doctor.  In Stage III and IV, the haemorrhoids are externally visible or palpable. Sometimes the closure of the anus is impaired by this and there is rectal urgency or undesired stool discharge.

The diagnosis can often already be made on the basis of the patient’s medical history in combination with a rectal examination with the finger. A colonoscopy of the rectum is sometimes carried out to rule out other causes for the symptoms.

The treatment of haemorrhoids depends on the stage of the disease and the severity of the symptoms. Haemorrhoids in State I and II can be treated conservatively with decongestant, anti-inflammatory and pain-relieving ointments or suppositories. Elimination of the chronic constipation is decisive for the success of the procedure. Fibre-rich food, sufficient fluid intake and regular exercise can counteract constipation.

If there are haemorrhoids in Stage III or IV, surgery is usually unavoidable. There are various methods available to surgically remove haemorrhoids. Find out more in the Anal surgery section.

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