For mild forms of hemorrhoids, it is usually sufficient to switch to a high-fiber diet and better bowel habits. Through the many fibers, chronic constipation can often be eliminated. Since this reduces the need to push so hard during bowel movements, the pressure on the blood vessels in the rectum is reduced, which can improve the hemorrhoidal condition. Under no circumstances should laxatives be used, as these lead to a worsening of the symptoms in the long term.
Numerous active substances are available to alleviate the symptoms with medication - these are usually applied to the haemorrhoids in the form of ointments or suppositories:
- For inflammation , the herbal active ingredient witch hazel is recommended. More effective are cortisone preparations such as prednisolone or hydrocortisone acetate. Until recently, preparations containing bufexamac were also recommended - however, these were withdrawn from the market in May 2010 as this active substance can trigger a contact allergy.
- Active agents like lidocaine, benzocaine, macrogollauryl ether, cinchocaine and quinisocaine help against itching and pain. These have a local anaesthetic effect.
- Escherichia coli bacteria promote the immune system of the intestinal mucosa. In this way they indirectly develop an anti-inflammatory effect and thus support wound healing.
Lukewarm sitz baths with tanning agents (for example oak bark extract) or the intake of stool softeners can also alleviate the symptoms. If you are out and about, the use of moist toilet tissues with anti-inflammatory and disinfecting ingredients is recommended.
In cases of moderate to severe discomfort, topical application of medication is sometimes no longer sufficient and outpatient measures or surgical interventions become necessary.
Outpatient measures would include:
- Sclerotherapy: In this procedure, a special fluid (for example, phenol almond oil, aethoxysclerol) is injected into the hemorrhoids, which scleroses and scars the blood vessels. The hemorrhoids then shrink and the symptoms improve. The treatment usually does not cause any pain, but the probability of a recurrence of the hemorrhoids is quite high.
- Infrared treatment: The tissue at the origin of the hemorrhoids is strongly heated by an infrared device, causing it to scab over and then recede. Recurrences are also common with this treatment.
- Rubber band ligation: In this procedure, the hemorrhoids are pinched off by a rubber band placed over them, causing them to fall off after a short time. This is the most common treatment for moderately severe hemorrhoids. Recurrences occur frequently.