Hemorrhoids – Causes, Symptoms, and Modern Treatment Options

What are hemorrhoids and what function do they have in the body?

Hemorrhoids are well-vascularized cushions in the anal canal. Together with the sphincter muscle, they ensure the fine closure of the bowel and prevent uncontrolled stool passage. Hemorrhoidal disease is only diagnosed when these vascular cushions enlarge, descend, or become inflamed, causing symptoms.

Hemorrhoids: What severity grades are there?

The classification of hemorrhoids from Grade I to Grade IV describes the severity of hemorrhoidal disease and refers to internal hemorrhoids. In Grade I, the vascular cushions are enlarged but do not protrude outward; symptoms usually manifest as occasional bleeding or slight burning. Grade II is characterized by hemorrhoids temporarily protruding from the anal canal during straining but retracting on their own. In Grade III, the prolapse persists and must be manually pushed back, with symptoms such as pain, moisture, or foreign body sensation significantly increasing. Grade IV describes a permanent prolapse that can no longer be repositioned and is often associated with severe symptoms, inflammation, or complications. The higher the grade, the more pronounced the symptoms and the more likely the need for further medical treatment.

Hemorrhoids Grade I

In Grade I hemorrhoids, the vascular cushions in the anal canal are enlarged but do not protrude outward. Symptoms are usually mild and mainly manifest as occasional bright red bleeding during bowel movements or slight burning. Pain generally does not occur, which is why this severity level often remains unnoticed for a long time.

Hemorrhoids Grade II

Hemorrhoids Grade II temporarily protrude from the anal canal during straining or bowel movements but retract on their own. Typical symptoms include bleeding, itching, burning, as well as an increasing feeling of pressure or a foreign body sensation. The complaints are more pronounced than in Grade I but are usually still well treatable conservatively.

Grade III hemorrhoids

With Grade III hemorrhoids, the prolapse persists and must be manually pushed back. In addition to bleeding, pain, oozing, mucus discharge, and a pronounced foreign body sensation often occur. Quality of life is significantly impaired, and further therapeutic measures are often required.

Grade IV hemorrhoids

Grade IV hemorrhoids are permanently prolapsed and can no longer be pushed back. They are often accompanied by severe pain, inflammation, swelling, or complications such as thrombosis. At this stage, surgical treatment is usually necessary, as conservative measures alone are no longer sufficient.

Causes of hemorrhoidal disease at a glance

The development of hemorrhoids is usually multifactorial. The most important contributing factors include chronic constipation with straining, a low-fiber diet, and insufficient fluid intake. Lack of exercise and prolonged sitting—especially on the toilet—increase pressure in the rectum. Other risk factors are pregnancy, overweight, frequent heavy lifting, and age-related changes in connective tissue. In some cases, chronic diarrhea or family predispositions also play a role.

Symptoms of hemorrhoids: Typical complaints by stage

The complaints depend on the location and severity of the hemorrhoids. Internal hemorrhoids often initially cause no pain but can be noticed by bright red bleeding during bowel movements. A foreign body sensation or oozing secretions are also possible. External hemorrhoids can manifest through itching, burning, swelling, or pain. Palpable lumps at the anus are typical. If a thrombosis occurs within a hemorrhoid, sudden severe pain and a noticeable hardening usually appear.

Which symptoms occur with hemorrhoids depending on the grade?

Recognizing hemorrhoids: When is a medical diagnosis advisable?

Persistent symptoms in the anal area should generally be medically evaluated, especially in cases of bleeding, severe pain, or lack of improvement. Diagnostics usually include a medical consultation, a physical examination, and—depending on findings—a scope examination of the anal canal or rectum. The goal is to accurately diagnose the hemorrhoidal condition and exclude other diseases.

Treatment of hemorrhoids: What therapy options are available?

The therapy is based on the severity of the complaints and is carried out in stages.

Conservative treatment for hemorrhoids

In early stages, lifestyle and dietary adjustments are the focus. A fiber-rich diet, adequate fluid intake, and regular exercise facilitate bowel movements and reduce pressure on the vascular cushions. It is also important to avoid straining and not to prolong toilet visits unnecessarily.

Local therapy for hemorrhoids

For acute symptoms, locally applied preparations such as ointments or suppositories are used. They can have anti-inflammatory effects, reduce swelling, and relieve itching or burning. These measures primarily serve symptom control and support healing.

Interventional and surgical procedures for advanced hemorrhoids

For advanced hemorrhoids or persistent symptoms, minimally invasive procedures such as rubber band ligation or sclerotherapy may be necessary. In severe cases, such as significant prolapse or recurring complications, surgical treatment is indicated. The choice of procedure is individualized and medically coordinated.

How CANNEFF® suppositories can be used as support for hemorrhoids?

CANNEFF® suppositories with CBD and hyaluronic acid can be used as an adjunct for internal and external hemorrhoids to relieve typical symptoms such as irritation, burning, a feeling of tension, and mucous membrane irritations in the anal area. The combination of CBD and hyaluronic acid acts locally as an anti-inflammatory, soothing, and mucous membrane-protecting agent while also supporting the moisturizing and regeneration of the sensitive anal mucosa.

As a medical device, CANNEFF® is not considered an alternative treatment method but a conventional, locally effective therapy option for mucous membrane-related symptoms in the context of hemorrhoidal disease. However, its use does not replace causal treatment of hemorrhoids. Especially in more pronounced, painful, or bleeding cases, medical evaluation and possibly further therapy are required.

Preventing hemorrhoids: What helps in the long term?

Sustainable prevention is primarily based on healthy bowel function. Regular exercise, a balanced diet with sufficient fiber, and mindful bowel habits are central measures. Avoiding prolonged sitting in daily life and on the toilet also helps relieve the anal area.

FAQ – Frequently Asked Questions about Hemorrhoids

What is the difference between hemorrhoids and hemorrhoidal disease?

Hemorrhoids are normal vascular cushions in the anal canal. Only when they enlarge, descend, or become inflamed and cause symptoms is it called hemorrhoidal disease.

Are hemorrhoids dangerous or in need of treatment?

In most cases, hemorrhoids are not dangerous but can significantly affect quality of life. It is important to have a medical evaluation to rule out other causes of bleeding or pain.

Can hemorrhoids regress on their own?

Mild symptoms can improve through lifestyle changes such as a high-fiber diet, sufficient fluid intake, and less straining. Advanced hemorrhoids usually require targeted treatment.

Is bleeding during bowel movements always due to hemorrhoids?

No. Other conditions such as anal fissures, inflammations, or bowel diseases can also cause bleeding. Therefore, persistent or recurring bleeding should always be medically evaluated.

When should one seek medical advice for hemorrhoids?

A doctor's visit is advisable for severe pain, visible lumps, persistent itching, oozing symptoms, or bleeding that lasts longer than a few days.

Do ointments and suppositories provide lasting relief for hemorrhoids?

Local preparations relieve symptoms such as itching, burning, and swelling, but usually do not treat the cause. They are mainly suitable as a supportive measure.

How can hemorrhoids be effectively prevented?

Yes. Regular exercise, a high-fiber diet, adequate hydration, and relaxed bowel movements without straining are key preventive measures.