Hemorrhoids – diagnosis and therapy

Hemorrhoids - diagnosis and therapy

Even if it is difficult for some: If you suspect haemorrhoids, you should not hesitate to consult a doctor as soon as possible – haemorrhoids are best treated early. If you suspect haemorrhoids, the family doctor and the proctologist are the right contact person.

Going to the doctor with haemorrhoids

In a conversation, the doctor will first determine the symptoms and ask specific questions about eating habits or going to the toilet.

Then the doctor will look at the anal area and feel it. Since the haemorrhoids are often deep in the anus and cannot always be felt, he will then perform an anal canal reflection (proctoscopy) or a rectal reflection (rectoscopy). The anal canal and its mucous membrane or the rectum are examined with a small tube (endoscope).

This allows various other causes, including severe diseases like carcinoma, to be ruled out. This examination may be perceived as unpleasant personally, but it is part of the doctor’s everyday routine. Usually, it is not painful.


Treatment of hemorrhoids

Keep the stool soft and ensure regular bowel movements to avoid straining when going to the toilet. However, it would help if you only went to the bathroom when you had to and avoided heavy straining.

Eating the proper diet is also important for haemorrhoids: increasing the fibre content and drinking enough fluids help get your digestion going again. Foods with a high fibre content are, for example, fresh fruit, cereals, legumes or vegetables.

This process can be supported by movement and physical activity. Obese people should try to reach their average weight. Careful hygiene in the anal region is also essential. Finally, pelvic floor exercises help promote blood flow.

Depending on the stage, the following treatment options are also used:

  • Locally applied suppositories, ointments or creams help against the symptoms of more minor haemorrhoids (grade I)
  • Sclerotherapy: Small and medium-sized haemorrhoids (grade I – II) can be sclerosed. A liquid is injected that causes the tissue to shrink.
  • An alternative to this is the ligature, in which the medium-sized haemorrhoids (grade II-III) are tied off with a rubber ring. The blood supply is interrupted, and the tissue dies or regresses.
  • Surgery: Grade III and IV haemorrhoids must be surgically removed, for example, by Longo surgery, Doppler-guided haemorrhoidal artery ligation (HAL), the stapled method or recto-anal sexy (RAR).

All other medical treatment options are no longer used either because of complications or poor effectiveness (e.g. cold treatment, infrared coagulation) or are not (yet) recommended because of insufficient studies (e.g. electrotherapy ).

Home remedies for haemorrhoids

If you suffer from haemorrhoids, visiting the doctor is usually unavoidable. In addition to sufficient exercise and the proper diet, home remedies can help to alleviate the symptoms that cause haemorrhoids. These include, for example, marigold ointment or sitz baths with chamomile or oak bark tea. You can find more tips and home remedies for haemorrhoids here.

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