In this blog post, we take a closer look at the causes of hemorrhoids (often called piles) and explore effective home remedies that provide relief. We also present a range of treatment options to help you make well-informed decisions. Because although hemorrhoids can be uncomfortable and distressing, there are effective strategies to manage them.

Summary:

There are various unpleasant conditions affecting the anal region and the anus, many of which are commonly referred to as hemorrhoids or piles. However, it is incorrect to label all complaints involving a swelling or bulge in the anus as hemorrhoids in the strict medical sense. As a result, the treatment approach may differ.

In the following, we provide an overview of common conditions affecting the anus or rectum to help identify genuine hemorrhoids. This is especially important because the area around the bowel, anus and rectum is still associated with significant shame and taboos, even though it plays an essential role in our well-being.

In addition to hemorrhoids, other conditions in this region may include skin tags (marisca), anal thrombosis, or even carcinoma. We will not discuss the latter in detail, as immediate medical attention is required.

What Are Hemorrhoids (Piles)?

Several structures interact in the rectum to ensure that the anus is properly closed. In addition to the pelvic floor muscles, the anal sphincter (sphincter ani) plays the key role. Deeper in the rectum is a network of small arteries and veins which regulates fine control for complete closure (especially with softer stools). This system is called the hemorrhoidal plexus and refers to a ring-shaped collection of hemorrhoids. The term therefore does not describe a disease, but rather a normal anatomical structure that contributes significantly to continence.

Strictly speaking, a pathological change should be termed as hemorrhoidal disease rather than simply hemorrhoids, but for the sake of simplicity we will use the common term.

Internal Hemorrhoids

Hemorrhoidal disease occurs when individual blood vessels in the hemorrhoidal plexus become enlarged or displaced for a variety of reasons and are categorized from grade 1 to grade 4. As long as the enlargement is mild and remains inside the rectum, it is referred to as internal hemorrhoids. These are often not noticed and cause little or no discomfort. If the causes are not addressed, internal hemorrhoids may swell further and protrude outward.

External Hemorrhoids

If the swollen tissue or protrusions can be felt on the outside of the anus, these are external hemorrhoids. These abnormal swellings or skin tags sometimes appear overnight and cause alarm. External hemorrhoids are usually noticed during cleaning after a bowel movement or due to itching, pain or bleeding.

Classification or Severity of Hemorrhoids

The classification of hemorrhoids is divided into the following grades:

Grade 1 hemorrhoids: Internal, with no or only minor symptoms.

Grade 2 hemorrhoids: Temporarily protrude from the anal canal – usually after a bowel movement – but then recede on their own.

Grade 3 hemorrhoids: Do not retract on their own but can be pushed back into the rectum manually using a finger or dilators (reduction).

Grade 4 hemorrhoids: Cannot be reduced manually and remain permanently outside the anal canal. These usually require surgery.

Anal Thromboses, Anal Fissures and Skin Tags

Hemorrhoids are often confused with other anal conditions, such as skin tags, fissures or anal thromboses. Here’s how to tell the difference:

Anal thrombosis is an acute condition: A clot forms within hours, creating a bluish-black, bulging lump with sharp pain. This usually occurs as a single event.

Skin tags (mariscae) are thickened folds of skin around the anus. They are harmless but can make cleaning more difficult, which may lead to itching or irritation.

Anal fissure is a longitudinal tear in the anal canal or sphincter muscle. Although fine on the outside, it can be deep and cause severe pain, especially during bowel movements.

Causes and Development of Hemorrhoids

Main causes include:

• Chronic constipation (low fiber, low fluid intake, sedentary lifestyle)
• Incorrect toilet habits (forceful straining)
• Overloading the pelvic floor (heavy lifting, obesity)
• Weak connective tissue (inherited tendency to varicose veins)
• Frequent diarrhea or laxative use
• Pregnancy and childbirth (read more)

Prevention and Home Remedies for Hemorrhoids

To prevent hemorrhoids and support their treatment, maintain a fiber-rich diet (vegetables, fruits, whole grains) and drink 2–3 liters of water daily.

Correct toilet posture: Avoid straining, breathe into your abdomen, and adopt a squatting-like position (see image):

Home remedies: Witch hazel ointments, naturopathic suppositories, cool sitz baths (sea salt or oak bark), quark compresses, decongestant nasal spray.

Effective Aids for Your Own Treatment: Viball® and FMS Dilators

FMS Dilators: High-quality tools made of borosilicate glass, ideal for repositioning hemorrhoids and cooling therapy.

Viball® Kegel Balls: Certified medical Kegel balls made of implant-grade steel for vaginal and rectal use – prevent recurrence and strengthen the pelvic floor.

Viball®: Post-Treatment of Hemorrhoids and Prostate Health

Viball® offers natural anti-inflammatory effects and supports long-term prevention.

This Might Also Interest You:

• Vaginismus and Vaginal Cramps
• Anal Fissure
• Pelvic Floor Training with Balls
• Kegel Balls: Effects & Differences