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From a purely anatomical point of view, hemorrhoids are sponge-like vascular pads (erectile tissue) at the exit of the rectum. They are located above and below the sphincter. Hemorrhoids ensure fine continence and, in conjunction with the sphincter, prevent gases and stool fluids from escaping from the anus. Accordingly, everyone has hemorrhoids. Doctors speak of a hemorrhoidal disease when these vascular cushions are enlarged and cause symptoms such as pain, burning or after itching.
Colloquially, such an enlargement of the hemorrhoidal pillow is meant when one speaks of hemorrhoids. An estimated 70 to 80 percent of all adults suffer from swollen hemorrhoids. There are several ways to treat hemorrhoidal disease. In particular, light forms and early stages can also be treated effectively with home remedies. In general, the earlier treatment is started, the easier and more effective it is.
Home remedies for hemorrhoids
In the context of conventional medical treatment measures, the blood supply to small hemorrhoids can be prevented by means of infrared or injection, and the enlarged vascular cushions can thus be obliterated. A so-called rubber band ligation can be used for larger hemorrhoids. This binds parts of the hemorrhoids and thus causes them to die. Surgical removal of the enlarged vascular pads can also be indicated.
To avoid such a surgical procedure, it is advisable to treat hemorrhoidal disease early. Many sufferers suffer from hemorrhoids in the first and second stages. In turn, more than 50 percent of these patients show spontaneous remission (spontaneous regression) even if there is no medical or conventional medical intervention.
Symptomatic treatment with home remedies can be particularly advantageous for mild to moderate hemorrhoids. They can alleviate symptoms such as anus burning, itching, oozing and other sensations in the anal area. The home remedies can also inhibit the progress of the enlargement and thus prevent further manifestation of the symptoms. But even with advanced hemorrhoids, home remedies can support conventional medical treatment. There are several simple remedies that can help with hemorrhoid symptoms. These are briefly presented below.
Quick help with hip baths
Sitz baths with nourishing and analgesic agents can provide quick relief from symptoms. Herbal active substances (phytopharmaceuticals) with a high proportion of tannins such as witch hazel (witch hazel) or oak bark are particularly suitable. Tannins have anti-inflammatory, astringent (contracting) and antimicrobial properties.
Sitz baths with these herbal ingredients are therefore able to inhibit inflammation in the area of the anus and thus reduce pain and itching. Depending on the individual symptoms, different phytopharmaceuticals come into question, since some of these have different effects:
- anti-inflammatory (anti-inflammatory) effect: witch hazel bark and leaves (Hamamelidis cortex and Hamamelidis folium), oak bark (Quercus cortex), chamomile flowers (Matricariae flos), butcher's broom rootstock (Rusci rhizoma), poplar buds (Populi gemma),
- contracting (astringent) and itch relieving Effect: Hamamelis bark and leaves (Hamamelidis cortex and Hamamelidis folium), oak bark (Quercus cortex), butcher's broom rootstock (Rusci rhizoma), poplar buds (Populi gemma),
- venon toning (vein strengthening) effect: Butcher's broom rootstock (Rusci rhizoma)
- or hemostatic (Hemostyptic) effect: Hamamelis bark and leaves (Hamamelidis cortex and Hamamelidis folium), oak bark (Quercus cortex).
Because of their broad spectrum of action, witch hazel and oak bark are particularly common in hemorrhoid treatment. Here oak bark offers itself primarily in the acute treatment and witch hazel in the treatment of both acute and chronic complaints. The lukewarm hip baths (at a maximum of 28 degrees Celsius) should be carried out once a day for acute complaints, later two to three times a week to prevent and prevent disease progression. In a first step, infusions are made from the selected plant parts:
Oak bark: Pour 300 milliliters of boiling water over three tablespoons of the shredded plant parts. Strain after about a quarter of an hour and add to the hip bath (= 20 liters of water).
Witch hazel: Drain five to ten grams of the cut or roughly pulverized (bark) plant parts with 200 milliliters of boiling water and strain after 10 minutes and add to the hip bath.
The bathing time should not exceed 20 minutes. Then the anal area should be carefully but carefully patted dry. If there is a cold setting, cold drying using the hair dryer is recommended.
Combination of hip baths and ointments
A combination of hip baths with subsequent application of ointments or creams has proven itself in hemorrhoid treatment. These can contain the same phytopharmaceuticals that are used for the hip baths. The purely external application is often not sufficient if the enlarged vascular cushions are still inside the anal canal.
The use of special applicators available in pharmacies is recommended. These are screwed onto the ointment tube and filled with pressure. The exit opening at the tip can be rubbed with a little ointment to improve the lubricity. Then the applicator is inserted and the contents are released by pressure. The ointment can be evenly distributed in the anal canal with a slight twisting motion.
Suppositories, on the other hand, tend to get past the hemorrhoids into the rectum (rectum). Only during the emptying of the stool do the active substances reach the intended place of action for a short time. The use of suppositories is therefore viewed rather critically.
Stool regulation through high-fiber diet and exercise
The basis of every curative and preventive hemorrhoid treatment is a healthy diet to promote regular bowel movements. Enlargement of the vascular cushions are increasingly caused by excessive pressure during defecation (defecation). In particular, people who frequently suffer from constipation tend to do this.
In the case of constipation, there is hard stool, which not only requires more pressing to empty the intestine, but can also damage the sensitive surface of the enlarged vascular cushions. The increased pressing in turn inhibits the blood drainage from the vascular pads required for the defecation. The stool should be soft, dry and shaped for undisturbed bowel movements.
To get a softer stool, a high-fiber diet, a sufficient amount of drink and enough exercise are sufficient in many cases. These stimulate the peristalsis (bowel activity), thus reducing the problems with emptying of the stool underlying the hemorrhoidal disease and thus also the associated complaints.
Diet rich in fiber
The daily intake of fiber-rich food increases the volume of the stool. This in turn leads to an improved bowel function, which prevents constipation. High-fiber foods are, for example, whole grains, wheat bran, oatmeal, legumes and generally vegetables and fruits (especially dried fruit).
White bread, white rice, white pasta, cocoa (chocolate), pureed bananas, grated apples, blueberries and black tea, on the other hand, promote constipation. Coffee, alcohol and spicy food irritate the intestinal mucosa. Sufficient fluid (at least 1.5 liters) should also be ingested so that the ingested fiber can swell up well for volume increase in the intestine. Because without sufficient liquid, the fiber absorbs the liquids from the intestine and thus promotes constipation. Here, water and unsweetened teas are preferable to sugary drinks such as lemonades.
In addition, it is recommended to gradually increase the fiber intake so as not to overload the intestine at the beginning and to avoid bloating. The taking of laxatives should always be discussed with a doctor. In the long term, these often lead to constipation and promote constipation.
Regular exercise promotes peristalsis (bowel activity) and keeps the bowels fit. Well-functioning digestion facilitates bowel movements and efficiently lowers the risk of constipation. In addition to a balanced and high-fiber diet, sufficient exercise is also a key factor in reducing excess weight. Overweight, in turn, is a risk factor for hemorrhoidal ailments because it can cause blood congestion in the vascular cushions.
If these measures are not sufficient, natural swelling agents can remedy the situation. Even a tablespoon of wheat bran, linseed and Indian psyllium in daily yogurt can help improve bowel function. In general, probiotic milk products such as yogurt or curd can support the intestinal flora and thus the digestion. If additional swelling agents are used, however, care must be taken to ensure a high fluid intake.
Important behaviors while using the toilet
A few behaviors when using the toilet can make it easier to empty the stool and thus reduce hemorrhoidal complaints. So it is recommended to avoid long stays in the toilet. These strain the blood vessels in the vascular cushions and lead to further expansion of the vascular cushions.
Presses should also be avoided while emptying the stool. Rather, an attempt should be made to relax the intestinal exit. With forced pressing during defecation, additional pressure is exerted on the buttocks. This leads to a permanent enlargement of the hemorrhoids. In addition, fixed toilet times (for example, always in the morning after breakfast) can support the intestines in their work.
Anal hygiene is important for hemorrhoid disorders
Emptying the stool should be completed with careful anal hygiene. Clear water or a pH-neutral, mild washing lotion is recommended. The anal area can be showered or carefully cleaned with a disposable washcloth. Moist toilet paper should not be used since it mostly contains substances that potentially irritate the anus area.
Generally, soft washcloths are recommended for dabbing the anal area instead of toilet paper. Final skin care can also be helpful.
Compresses for additional care of the anal skin
Compresses can also be used for additional anal care. The same active ingredients (including witch hazel, oak bark) are available here, which are also used in hip baths or ointments. Oil-soaked fleece or cheesecloths can also be applied in the butt fold to soothe and care. Because of its skin tolerance, olive oil has proven itself (ideally with organic certification). This can also be enriched with essential oils such as lavender or tea tree oil. For this, a few drops should be added to a tablespoon of oil.
Causes of Hemorrhoids
The exact cause of the development of enlarged hemorrhoids has not yet been conclusively clarified. The weakened connective tissue is held responsible as we get older, as the 45- to 65-year-olds are most often affected by hemorrhoids. In addition, stool regulation problems, shear forces during the passage of hard stool, excessive pressing during defecation (defecation), blood congestion and inadequate drainage of the venous blood, as well as increased pressure in the vessels can cause the vascular cushions to expand.
The following factors also favor the development of hemorrhoidal disease:
- a low-fiber diet,
- Tendency to constipation,
- Obesity (overweight),
- Lack of exercise,
- and long stays in the toilet.
Certain medications such as laxatives and diarrhea, active ingredients for erectile dysfunction treatment (phosphodiesterase 5 inhibitors) and non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of hemorrhoids. It is also assumed that there is an inherited disposition to develop extensions to the vascular cushions.
Complaints depend on the stage of the disease
In hemorrhoids, the symptoms change with increasing size of the vascular pad expansion. Even with small enlargements of the hemorrhoidal pillow, the mucous membrane is stretched over the vascular pads. When pressing or during the passage of hard stool, small blood vessels in the mucous membrane can tear easily and lead to bleeding. These either lie on the chair or toilet paper or drip on.
Hemorrhoid bleeding is bright red due to arterial blood leakage. Dark red blood indicates venous blood and thus another bowel disease as the cause of the bleeding. The bleeding is mild at the beginning, but may become more severe as the disease progresses. Pain often does not occur at this stage (stage 1). If there is an additional loss of secretion and mucus as a result of a disturbed fine closure, the anal mucosa is irritated (stage 2). Itching, oozing, sore skin, underwear contaminated with stool (stool incontinence) and pain occur.
In the further course, the enlargements of the vascular pads fall out of the anal canal and are palpable as protrusions (stage 3). Here, doctors speak of prolapsing hemorrhoids. These are often accompanied by a foreign body sensation in the anal area, difficulty in sitting, constant urge to stool or a feeling of incomplete emptying of the stool. Although diarrhea is not a typical hemorrhoidal symptom, diarrhea can also occur in the course of the disease. These should also be treated because the anal skin is additionally irritated here.
The combination of hip baths, ointments and a change in diet to high-fiber food has proven itself in the early stages (1 and 2) as a symptomatic treatment to relieve the symptoms. The progression of the disease can often be slowed down or even stopped. From a certain hemorrhoid size or if there are late symptoms, a doctor should be consulted. This can also rule out other diseases such as anal fissures, skin tags or tumors. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
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ICD codes for this disease: K64ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.