We free you from your suffering due to haemorrhoids

Everyone has haemorrhoids (also known as piles). These are usually three blood cushions that sit just inside the anus. However, haemorrhoids only become a disease when they are permanently enlarged.
At Schoen Clinic, the stage-appropriate, modern treatment of haemorrhoids is one of our main areas of focus. Our experts in the specialised hospitals are recognised proctologists, who are continuously trained to free you from your haemorrhoids with state-of-the-art methods.

Causes & symptoms

What are haemorrhoids?

The word haemorrhoid comes from the Greek and means “flowing blood” (haima = blood, rhein = flowing). Everyone has haemorrhoids: They are usually three blood cushions, which sit just inside the anus. They are normally filled with blood and thus – in addition to the two sphincters – seal the anus like a valve. Doctors talk of fine continence. During a bowel movement, the blood withdraws from the haemorrhoids and the anus opens. However, if the haemorrhoids are permanently enlarged, they can cause symptoms such as pain, itching or bleeding. Proctologists speak of haemorrhoids, while, in common parlance, people say “I have piles”. Only then do the haemorrhoids become a disease. Anyone can be affected, regardless of their age.

Haemorrhoidal conditions can be divided into four stages:

  • Stage I: The haemorrhoids are slightly enlarged and can only be seen with the proctoscope.
  • Stage II: The haemorrhoids can be palpated as enlarged using a finger. They emerge from the anus during a bowel movement and then recede into the anal canal on their own.
  • Stage III: Voluminous nodes are palpated that emerge from the anus during a bowel movement and have to be pressed back in with a finger.
  • Stage IV: There are large nodes outside the anus that cannot be pushed back in. This often occurs in connection with a prolapse of the anal mucosa, called anal prolapse.
In stage III and IV, one often speaks of “external haemorrhoids”, since the nodes can be palpated outside the anus. The subdivision into “internal haemorrhoids” and “external haemorrhoids” is no longer valid today, however, since “external haemorrhoids” are frequently understood to be anal venous thromboses.

Anal venous thrombosis

Anal venous thromboses are an independent and completely different clinical picture than “external haemorrhoids” with a different treatment strategy. They result in a sudden, very painful swelling caused by a blood clot.

Causes: How an enlargement of the haemorrhoids occurs.

The development of enlarged haemorrhoids is influenced by many factors:
  • Significant straining during a bowel movement, caused by a hard bowel movement and chronic constipation.
  • Frequent diarrhoea can also lead to an enlargement of the haemorrhoid cushions, as these must constantly retain the liquid stool. This means that the blood cushions are permanently filled, which impairs fine continence. 
  • Pregnancy, being overweight and sedentary activities also prevent the outflow of blood from the haemorrhoids.

How you can prevent haemorrhoids:

  • a healthy, balanced diet with lots of fibre and, to prevent constipation:
  • Sufficient fluid intake of around 1.5 litres of water or non-sweetened drinks per day, so that the dietary fibre can swell inside the bowel
  • Regular physical exercise


The permanent intake of laxatives is not an alternative to a healthy lifestyle! Please discuss the use of laxatives with your doctor.

Symptoms: How haemorrhoids become noticeable

Itching, a recurrent foreign body sensation or burning are symptoms of permanently enlarged haemorrhoids. This is sometimes joined by pain in advanced stages. The evacuation of mucus sometimes also occurs. Bleeding can occur, often during or after defecation. Sometimes you can find a larger amount of light red blood on the stool. If the haemorrhoids are advanced, they can be palpated outside the anus (stage II) or must even be pushed back in (stage III). In common parlance, these are referred to as “external haemorrhoids”. If the haemorrhoids are always outside the anus (stage IV), this is very painful and can lead to heavy bleeding.


Diagnosis: How we diagnose enlarged haemorrhoids

Taking note of your individual medical history already gives us a very good impression of your clinical picture. We will then examine you in several stages on the proctological chair. The examinations are carried out professionally and carefully by our specialists. Firstly, the observation (inspection) of the anus region for pathological changes is carried out, then the palpation of the anal canal using a finger (digital rectal examination). Finally, the first six centimetres of the anal canal and rectum are examined for bleeding, haemorrhoids and tumours with the short proctoscope (anoscopy), then the next ten to fifteen centimetres with the longer rectoscope (rectoscopy). Especially with the proctoscope, we can even diagnose slightly enlarged haemorrhoids.