Hemorrhoids Self-Treatment: Causes, Symptoms, Similar Conditions and All Treatment Options

 this guide, you will find well-founded, practical information about hemorrhoids: their causes and symptoms, how to distinguish them from similar conditions in the anal area, the different types of treatment and, above all, effective alternatives. Our aim is to provide reliable guidance so that you can correctly assess your symptoms and make informed decisions about self-treatment to combat them effectively and avoid surgery.

Your Benefit:
The information in this guide is not based on AI-generated editorial content, but on many years of therapeutic experience and communication with affected individuals, as well as expertise in the development and production of aids for the natural treatment of hemorrhoids.

In addition to medical background knowledge, proven home remedies and conventional treatments, you will learn about high-quality mechanical aids that have proven very helpful in practice for many people: certified medical devices designed not only to help treat hemorrhoids, but also to help you reconnect with your body.
This renewed body awareness can noticeably support your healing process and at the same time enrich your sensual experience.

You will also find information about related conditions in further guides.

Contents:

Classification or Grades of Hemorrhoids

Hemorrhoids are classified into the following grades:

Grade 1 Hemorrhoids
refer to the internal form with no or only minor symptoms.

Grade 2 Hemorrhoids
means that they temporarily protrude from the anal canal – usually after a bowel movement – but then retract spontaneously or gradually on their own.

Grade 3 Hemorrhoids
describes the form that does not retract into the anal canal by itself but can be pushed back manually with a finger or with suitable dilators (see below). This process is known as repositioning.

Grade 4 Hemorrhoids
is the classification for the stage at which even repositioning is no longer possible and the hemorrhoids remain permanently outside. Grade 4 hemorrhoids can generally only be removed surgically.

Other Conditions of the Anal Area

There are various unpleasant conditions affecting the anal region and anus that are often generally referred to as hemorrhoids in everyday language. However, this is not correct: not every thickening, fold of skin or bulge around the anus is a hemorrhoid, and the treatment approaches therefore differ as well.

Below, we provide an overview of the different conditions affecting the anus and rectum so that they can be distinguished more reliably: anal skin tags, anal fissures and anal vein thrombosis. In rare cases, changes in this region may indicate anal cancer, which requires urgent medical attention.
Typical symptoms and appearances of these conditions are described below.
To begin with, here is an image of external hemorrhoids for comparison:

It is important to understand that there is no single “typical appearance” of hemorrhoids; they can look very different depending on their grade, location and current condition. While early stages are often barely visible externally, advanced hemorrhoids protrude clearly. These differences are illustrated in the grading diagram above. The image shown here depicts prolapsed hemorrhoids (Grade 3) and serves as a comparison with other anal conditions.

Anal Skin Tag

An anal skin tag is a relatively harmless condition consisting of a thickened fold of skin in or around the anus. Skin tags may occur singly or in groups. They are usually skin-coloured to dark, soft to the touch and resemble small pouches or flaps of skin. Normally they cause no pain or discomfort, but because they can make cleaning the anus more difficult, itching and, in severe cases, inflammation may occur.

Anal Fissure

An anal fissure (visible in the upper centre of the image) is a longitudinal tear in the sphincter muscle or anal canal and is therefore sometimes incorrectly referred to as an anal tear. Although it often appears very small externally, it can extend deeply and cause severe pain, especially during bowel movements, cleaning after bowel movements or showering. However, no tissue protrudes externally and there is no sensation of a foreign body, which clearly distinguishes an anal fissure from hemorrhoids. Further information can be found in our guide Anal Fissure.

Perianal Thrombosis

Perianal thrombosis, sometimes also called perianal venous thrombosis, differs from the other conditions because it is an acute event. Within a few hours, a blood clot develops at the anal margin, usually appearing as a bluish-black, tense lump. Another clear sign is severe, stabbing pain. Perianal thrombosis usually occurs as a single lesion and is not the same as a hemorrhoid. However, in English-speaking countries it is often referred to as a “thrombosed external hemorrhoid”, even though it is a different condition.

Anal Cancer

Anal cancer (the tumour-like tissue change visible in the centre of the image) is a malignant growth affecting the anal canal or the skin near the anus. It may initially present with non-specific symptoms such as persistent itching, bleeding, weeping or poorly healing skin changes, as well as pressure or a sensation of a foreign body in the anus. Unlike acute conditions, symptoms usually develop gradually over weeks or months. Pain may occur, but is often absent in the early stages. Any unexplained changes in the anal region or changes that do not heal despite treatment should therefore always be examined by a doctor.

If you are unsure whether you have hemorrhoidal disease or anal cancer, a medical examination should clarify the diagnosis before you begin self-treatment.

Causes of Hemorrhoids

The most common causes of hemorrhoids are:

Chronic Constipation

This often results from a combination of a low-fibre diet, insufficient fluid intake and lack of exercise, often associated with a sedentary lifestyle.

Incorrect Bowel Habits

Rushed visits to the toilet, frequent and excessive straining during bowel movements, often combined with an unfavourable sitting position. This is particularly common among people suffering from chronic constipation.

Excessive Strain on the Pelvic Floor

Incorrect lifting of heavy loads, excess body weight and/or pelvic floor weakness can also contribute to the development of hemorrhoids.

Weak Connective Tissue

A hereditary weakness of the connective tissue, which may also manifest itself elsewhere in the body as varicose veins, is another possible cause.

Frequent Diarrhoea or Frequent Use of Laxatives

...can cause excessive stretching of the hemorrhoidal cushion and thereby create the conditions for hemorrhoidal disease.

Pregnancy and Childbirth

Women are particularly prone to developing hemorrhoids because of hormonal influences and the natural physical strain associated with this period of life. You can find all the information on how to prevent them or get rid of them quickly in our guide Hemorrhoids (Piles) After Birth or Pregnancy.

Preventing Hemorrhoids

To help prevent hemorrhoids and support treatment, your diet should be high in fibre in order to promote healthy and uncomplicated digestion. Fibre consists largely of indigestible food components, mainly carbohydrates, found in plant-based foods such as fruit, vegetables and grains, and helps prevent digestive problems.

Adequate fluid intake of around 2 to 3 litres per day, primarily water, helps maintain a soft stool consistency and makes bowel movements easier.

Correct behaviour during bowel movements is important. Avoid straining and excessive pressure; instead, try to “push” using your abdomen: take a deep breath and direct the air as far down into your abdomen as possible. The correct posture also helps: a rounded back and feet flat on the floor. Rather than the upright, “civilised” sitting position, your posture should resemble the original position that is most natural and effective for bowel movements – the squat. A footstool can help you achieve this position.

Why does this matter?
The levator ani muscle – or simply the levator ani – is a key muscle of the pelvic floor. In everyday life, it keeps the anus and rectum slightly elevated and thereby contributes to reliable closure. Its innermost part, the puborectalis muscle, forms a sling around the rectum. In an upright position, it creates a slight bend in the rectum and therefore plays an important role in continence. When this muscle relaxes – particularly in a squatting position or when leaning forward – the rectum straightens. This makes bowel movements significantly easier and reduces unnecessary straining.

The following illustration shows the different positions and their effect on the puborectalis sling:

Anal hygiene after using the toilet should be thorough. After an initial dry cleaning with soft toilet paper, a wet cleaning should always follow, ideally using water, for example with a hand shower, bidet or portable bidet. When travelling, wet wipes may occasionally be used instead. It is important to ensure that they contain as few additives as possible and ideally only water. Otherwise, the sensitive mucous membrane may become irritated and its natural flora disrupted. It should also be noted that most wet wipes must not be flushed down the toilet and should instead be disposed of in a bin. Finally, the anal area should be dried with toilet paper.
This helps remove the conditions that promote inflammation and prevents irritation of the skin’s pH balance. If necessary, a healing ointment or hemorrhoid cream can then be applied.

Home Remedies for Hemorrhoids

If you wish to treat hemorrhoids without medications containing chemical active ingredients, the following home remedies and natural treatments may help:

• Suppositories containing stibium metallicum and horse chestnut bark extract
• Ointments containing hamamelis (witch hazel)
• Ointments and pastes containing zinc or panthenol

The following can help with severely swollen or inflamed hemorrhoids:

• Cool sitz baths with sea salt or oak bark
• Quark compresses
• Nasal spray, because it has a decongestant effect

The measures listed above are not only important for effective treatment of existing hemorrhoids but also for prevention.

In addition to suppositories, ointments and medications, there are also excellent mechanical aids:

Alternative Aids for Treating Hemorrhoids

We would like to introduce two aids that can be used individually or in combination to treat hemorrhoids effectively yourself:
“Theros® FMS Dilators” and “Viball® Therapy Balls”.

Both product lines are certified medical devices with proven effectiveness. Their application safety is confirmed by the CE mark.

In addition to hemorrhoids, they are used for many other conditions affecting the body's centre, including pelvic floor weakness, prostate or erectile problems, vaginismus, injuries, surgical after-effects and many other vaginal or anal conditions (links to all applications can be found on the respective product pages).
In this guide, however, we will focus specifically on their use for hemorrhoids.

Theros® FMS Dilators

Theros® FMS Dilators are high-quality, handmade glass dilators made from borosilicate glass for the vaginal or rectal treatment of a wide range of conditions affecting women, men and people of all genders, including vaginismus, anal spasms, prostate problems and many others.
The extremely smooth and hygienic material, combined with 27 different sizes, allows exceptionally gentle use, even in the presence of inflamed hemorrhoids. Theros® FMS Dilators are certified medical devices with clinically proven effectiveness.

Repositioning Hemorrhoids With FMS Dilators

The term repositioning refers to pushing a hemorrhoid back into the hemorrhoidal cushion from which it has protruded. This is normally done with a finger. The problem is that the contact area is very small, allowing the hemorrhoid to slip away sideways, especially if it is larger. Even when successful, the pressure is often not distributed broadly enough, making the repositioning only partially effective. As a result, hemorrhoids often protrude again after some time, meaning that repeated repositioning is usually required throughout the treatment period.

FMS Dilators are ideal for repositioning because the wide range of sizes allows optimal adaptation to your body and provides broad support.
With Theros® FMS Dilators, successful repositioning is not uncommon even on the first attempt. For repositioning, you should choose the largest dilator you can comfortably use, because it reduces the space available for the hemorrhoid to move away inside the rectum.

However, this is virtually impossible with a single dilator.
A set of dilators is required for the treatment of hemorrhoids.
The following factors influence the choice of the most suitable size or sizes:

• Your individual physique and anatomical characteristics,
• The current grade and condition of your symptoms,
• Your emotional and psychological state: if you are tense, this also affects the anal region, meaning that smaller sizes may be required.

Additional reasons for using a dilator set:

• You can gradually increase the size by using successive dilators one after another. This enhances the effectiveness of repositioning, while increasing flexibility in the anal region, which is one of the best ways to prevent hemorrhoids from recurring.
• Men can also use FMS Dilators to massage the prostate and thereby support erectile function.

We offer various dilator sets at special prices, or you can create your own individual set with discounts of up to 20%. Under “How do I determine the correct size?” we provide guidance on selecting suitable sizes.

How to Use Them for Repositioning:
Begin with a dilator size that you can insert comfortably and use it together with a high-quality medical lubricant. By gently moving the head of the dilator back and forth several times at the narrowest point, the sphincter muscle gradually relaxes, allowing you to insert the next size after a while. Increase the sizes according to your individual possibilities. This improves the effectiveness of repositioning because the rectum is filled more completely, helping to push the hemorrhoid back into the hemorrhoidal cushion. Leave the final and largest dilator in place for approximately 10 minutes.
Note: Ideally, repositioning should be performed with a dilator of approximately 32 mm or larger. If you are experienced with rectal insertion or if the severity of your condition allows it, considerably larger dilators can also be used.

Viball® for Repositioning and Stabilisation

Due to their presence inside the rectum, Viball® Kegel balls / therapy balls help prevent hemorrhoids from protruding again after repositioning. Through our communication with clients, we are aware of cases in which hemorrhoids that developed after childbirth disappeared through the use of Viball® alone.
Anti-Inflammatory and Decongestant Effects
Anti-allergenic stainless steel has a moderating effect on body temperature and helps swelling subside quickly. Inflammation is effectively reduced because the increase in temperature required for inflammation is transferred directly from the affected area into the material.

At the same time, the intense vibrations stimulate the pelvic floor muscles and, in men, also support prostate function.

Cold Therapy With Viball®

The type of cold therapy described above for FMS Dilators can even be performed with Viball® in a frozen state:
The solid inner ball retains its temperature for a very long time because of its insulation. However, this also means that it takes several hours for the inner ball to cool completely. When in contact with the body, the thin-walled outer ball quickly warms to body temperature while the inner ball remains cool – resulting in gentle cooling that can last for hours. Swelling of the hemorrhoids decreases, and the temperature increase required for inflammation cannot develop in the first place.
Further information and practical tips can be found in the instructions for use.

Although the intense vibration generated during movement does not play a direct role in this type of cold therapy, it strongly stimulates the pelvic floor muscles, reliably helps with incontinence and promotes prostate function.

Here you can find out how to determine the correct size for you: Viball® FAQ