Haemorrhoids, Fistulas & Fissures
Comprehensive medical information on diagnostic procedures, symptoms, and modern treatment options in rectal and anal medicine.
Painful lumps in the anal region, sometimes with itching, pain during bowel movement, burning, bleeding or other problems are common symptoms! Often these are completely wrongly concealed!
Most of the time, it is a well treatable disorder. However, a thorough examination is always recommended so that even serious causes can be identified in time.
Many basic principles of haemorrhoidal disease are better understood today. All established treatment methods are available from us. Should an operation be necessary, "Proktologie Prinzregenten 121" uses without exception gentle and painless procedures, which have also proven to be comfortable according to international experience.
In connection with the aforementioned conditions, fissures (painful cracks) in the anal region are also very common, which are generally misinterpreted as haemorrhoids. This often very persistent change over the years, for which many affected people often spend a lot of money for self-treatment, can in suitable cases also be surgically removed.
It is important to distinguish it from a fistula disease. This inflammatory disease, which usually results from abscesses and usually requires surgical treatment, is carried out by us in such a way that the sphincter muscle is not split and thus continence is always maintained.
All of the above-mentioned diseases are suitable, if left untreated for many years, for promoting incontinence (weakness of stool) in addition to age-related tissue weakness.
Patient Downloads
In the following we have prepared some information documents (in German) as PDF-File for you to download.
Haemorrhoids (Hemorrhoidal cushions)
Haemorrhoids are natural cushions of vascular tissue (cavernous bodies) located at the exit of the rectum. Working in conjunction with the anal sphincter muscle, they ensure airtight and watertight closure of the anus. Only when these cushions become pathologically enlarged and cause symptoms like itching, burning, oozing, or bleeding does one refer to haemorrhoidal disease.
Grading & Symptoms
- Grade I: Only visible via proctoscopy, painless, occasional bright red bleeding.
- Grade II: Prolapse during straining but reduce spontaneously (slide back in).
- Grade III: Prolapse during straining or walking, requiring manual reduction (pushing back in).
- Grade IV: Permanently prolapsed, cannot be reduced manually (fixed prolapse).
Modern Treatment Methods
The choice of therapy depends strictly on the respective stage of the disease:
- Conservative (Grade I-II): Rubber band ligation, sclerotherapy (injection treatment), and dietary advice to regulate stool.
- Surgical (Grade III-IV): Gentle stapled haemorrhoidopexy (Longo procedure) or classic surgical reconstruction with maximum sphincter preservation.
Anal Fistulas and Abscesses
An anal abscess is an acute purulent infection in the tissue surrounding the anus. It is usually caused by an infection of the proctodeal glands located in the area of the sphincter. An anal fistula frequently develops from an abscess – a small, chronically inflamed tunnel connecting the gland with the surface of the skin.
Symptoms & Urgency
An abscess manifests as progressive, often throbbing pain, redness, swelling, and fever. This constitutes an acute medical emergency that requires timely surgical drainage to prevent widespread tissue damage. Anal fistulas, on the other hand, lead to chronic discharge (pus/wound fluid), itching, and occasional pain.
Therapeutic Options
Fistulas rarely heal spontaneously and usually require surgical intervention to prevent recurring abscesses:
- Abscess Incision: Acute surgical opening for drainage and pressure relief (usually outpatient).
- Fistulotomy (Fistula Division): Completely cutting open or removing the fistula tract in superficial cases without risk to the sphincter.
- Sphincter-Sparing Plastics: Mucosal advancement flap procedures or thread drainages (setons) for complex fistulas passing through the sphincter muscle.
Anal Fissure (Tear in the anal canal)
An anal fissure is a painful tear in the sensitive skin lining the anal canal. It typically occurs due to hard stools, chronic diarrhoea, or mechanical stress. The sharp pain during defecation often causes a reflex spasm of the internal sphincter muscle, which reduces blood flow and further hinders wound healing.
Symptoms
- Sharp, long-lasting pain during and after bowel movements.
- Bright red blood on the stool or toilet paper.
- Accompanying persistent itching and burning sensation in the anal region.
Therapeutic Concept
The primary goal is to relax the sphincter muscle to break the vicious cycle of pain and spasm:
- Conservative Treatment: Special relaxing ointments, training with an anal dilator, and a high-fibre diet to regulate stool consistency.
- Surgical Intervention: Fissurectomy (removal of the chronically altered fissure tissue) with absolute protection of the sphincter muscle if conservative therapy fails to heal after several weeks.
Do you have symptoms or questions?
Please do not hesitate to arrange a consultation at our clinic. Early diagnosis usually allows for gentle, purely conservative treatment options.
Book Online Appointment