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Background <p>Hemorrhoidal disease is a&#xa0;common, yet highly subjective condition and therefore represents a&#xa0;significant cost factor in the healthcare system. Despite numerous scientific studies the pathogenesis of hemorrhoids remains unclear.</p> Aim of this study <p>Based on current literature this study presents the current understanding of the pathogenesis of enlarged hemorrhoids and hemorrhoidal disease.</p> Material and methods <p>This study is based on the current German S3 guideline on hemorrhoidal disease from 2019. In addition, a&#xa0;focused literature search was conducted in PubMed and selected original articles and reviews were evaluated and discussed, taking our own experience into account.</p> Results <p>While numerous studies aim to clarify the pathogenesis of hemorrhoidal disease, these often exhibit several methodological flaws. This limits their conclusiveness. Key risk factors include constipation, straining during defecation and prolonged toilet sessions. Molecular mechanisms involve an inflammatory response mediated by proinflammatory cytokines, increased angiogenesis and degeneration of the surrounding connective tissue.</p> Conclusion <p>In addition to the generally assumed risk factors for the development of hemorrhoids, in recent years it could be shown that genetic and epigenetic components also play a&#xa0;role. For further research into the causes long-term studies are indicated.</p>

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Genese des Hämorrhoidalleidens

  • 期刊论文

  • 发表日期：

    2026年3月25日

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  • Jessica Schneider,
  • Volker Kahlke

摘要

Background

Hemorrhoidal disease is a common, yet highly subjective condition and therefore represents a significant cost factor in the healthcare system. Despite numerous scientific studies the pathogenesis of hemorrhoids remains unclear.

Aim of this study

Based on current literature this study presents the current understanding of the pathogenesis of enlarged hemorrhoids and hemorrhoidal disease.

Material and methods

This study is based on the current German S3 guideline on hemorrhoidal disease from 2019. In addition, a focused literature search was conducted in PubMed and selected original articles and reviews were evaluated and discussed, taking our own experience into account.

Results

While numerous studies aim to clarify the pathogenesis of hemorrhoidal disease, these often exhibit several methodological flaws. This limits their conclusiveness. Key risk factors include constipation, straining during defecation and prolonged toilet sessions. Molecular mechanisms involve an inflammatory response mediated by proinflammatory cytokines, increased angiogenesis and degeneration of the surrounding connective tissue.

Conclusion

In addition to the generally assumed risk factors for the development of hemorrhoids, in recent years it could be shown that genetic and epigenetic components also play a role. For further research into the causes long-term studies are indicated.