Natural cushions of tissue filled with many blood vessels are responsible for closing the anus and preventing leakage.


Natural cushions of tissue filled with many blood vessels are responsible for closing the anus and preventing leakage. Haemorrhoids occur when these vessels swell and become inflamed. Haemorrhoids differ in terms of severity and can cause complaints that range from itching to bleeding. A high-fibre diet helps to prevent this condition.


Haemorrhoids are assigned four different grades of severity:

  • Grade one: The haemorrhoids remain unnoticed inside the anus and don't cause any complaints
  • Grade two: The haemorrhoids come out of the anus when straining or during a bowel movement, presenting as a soft or rough swelling
  • Grade three: The haemorrhoids come out of the anus when straining and don’t go back inside on their own, but have to be pushed back inside with a finger
  • Grade four: It is no longer possible to push the haemorrhoids back inside and they remain touchable and visible outside the anus

Main symptoms

  • Burning and itching
  • Inflamed anus
  • Pain during bowel movements
  • Bright red blood on toilet paper
  • Mucous discharge
  • Soiling


  • Tears in the lining of the anus (anal fissure)
  • Infections, in rare cases abscesses (collection of pus, anal abscess)
  • Thrombosed haemorrhoid (blood clot in the haemorrhoid): sudden and very painful bluish lump at the anus

Causes and treatment


Various factors promote the occurrence of haemorrhoids:

  • Habitually straining too long for a bowel movement
  • Congenital weakness of the connective tissue
  • Chronic constipation
  • Low-fibre diet
  • Constant diarrhoea and laxative abuse
  • Obesity
  • Sitting down for extended periods
  • Lack of exercise
  • Pregnancy, giving birth

Further treatment by your doctor / in hospital

Possible tests
  • Physical examination of the anal region
  • Endoscopy of the rectum (proctoscopy)
  • Endoscopy of the colon (colonoscopy)
Possible therapies
  • Anti-inflammatory and anti-swelling tablets, suppositories, ointments and lotions
  • Elastic band tied around the base of individual haemorrhoids (rubber band ligation)
  • Injection treatment / heat treatment for individual haemorrhoids (fall off on their own)
  • Thrombosed haemorrhoids can be removed by a small incision

What can I do myself?

Haemorrhoids only require treatment if they are causing other complaints. The following should be noted:

  • Anal hygiene: clean yourself with chamomile lotion or wet hygiene wipes after a bowel movement
  • High-fibre diet (soft stools)
  • Adequate fluid intake (soft stools)
  • Physical activity promotes digestion
  • Avoid obesity, food causing flatulence, sitting down for extended periods and sitting too long on the toilet

When to see a doctor?

  • The first time you see blood in your stool
  • If your bowel movements have been irregular recently
  • If your haemorrhoids and their effects bother you


abscess, Haemorrhoids

Exclusion of liability

CSS offers no guarantee for the accuracy and completeness of the information. The information published is no substitute for professional advice from a doctor or pharmacist.

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