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article 
App\Entity\Article {#528
  -id: 6
  -title: "Jucken, Brennen, Nässen – gegen vergrößerte Hämorrhoiden lässt sich etwas tun"
  -teaser: "<p>H&auml;morrhoiden sind ein Bestandteil der normalen Anatomie.&nbsp;Nur wenn die Polster gr&ouml;&szlig;er werden und Beschwerden verursachen, handelt es sich um eine krankhafte Ver&auml;nderung.</p>"
  -content: """
    <p>Wer im Bereich des Afters ein Jucken, Brennen oder N&auml;ssen versp&uuml;rt, spricht h&auml;ufig davon, &bdquo;H&auml;morrhoiden&ldquo; zu haben. Doch H&auml;morrhoiden haben alle Menschen, sie sind ein Bestandteil der normalen Anatomie. Die ringf&ouml;rmig angeordneten, gut durchbluteten Gef&auml;&szlig;polster sitzen am Ausgang des Enddarms, kurz vor dem After. Zusammen mit dem Schlie&szlig;muskel sorgen sie daf&uuml;r, dass der Darm nach au&szlig;en richtig schlie&szlig;t.<br />\r\n
    <br />\r\n
    Nur wenn die Polster gr&ouml;&szlig;er werden und Beschwerden verursachen, handelt es sich um eine krankhafte Ver&auml;nderung. &Auml;rzt*innen sprechen dann von einem H&auml;morrhoidalleiden, einer der h&auml;ufigsten Erkrankungen in den Industrienationen. Am h&auml;ufigsten haben Menschen im Alter von 45 bis 65 Jahren vergr&ouml;&szlig;erte H&auml;morrhoiden. In Deutschland werden sch&auml;tzungsweise etwa 3,3 Millionen Patient*innen j&auml;hrlich aufgrund von H&auml;morrhoiden behandelt.<sup>1,2</sup></p>\r\n
    \r\n
    <h2>Wie kommt es zu einem H&auml;morrhoidalleiden?</h2>\r\n
    \r\n
    <p>Was die Ursachen f&uuml;r ein H&auml;morrhoidalleiden angeht, hat die Forschung bislang noch keine eindeutigen Ergebnisse. Es wird vermutet, dass H&auml;morrhoidalleiden entstehen, wenn das Gewebe, das die H&auml;morrhoiden st&uuml;tzt, schw&auml;cher wird. Das ist zum Beispiel mit zunehmendem Alter der Fall.</p>\r\n
    \r\n
    <p>Einige Risikofaktoren, die die Entstehung eines H&auml;morrhoidalleidens beg&uuml;nstigen, wurden jedoch identifiziert. Die gute Nachricht ist, dass sich viele von ihnen durch einen gesunden Lebensstil g&uuml;nstig beeinflussen lassen:</p>\r\n
    \r\n
    <ul>\r\n
    \t<li>&Uuml;bergewicht</li>\r\n
    \t<li>harter Harter Stuhl</li>\r\n
    \t<li>h&auml;ufige H&auml;ufige sitzende T&auml;tigkeit</li>\r\n
    \t<li>chronische Chronische Verstopfung</li>\r\n
    \t<li>h&auml;ufiger H&auml;ufiger Durchfall</li>\r\n
    \t<li>lange Lange Toilettensitzungen</li>\r\n
    \t<li>Schwangerschaft und Geburt</li>\r\n
    \t<li>genetisch Genetisch bedingte Veranlagung<sup>1,2</sup></li>\r\n
    </ul>\r\n
    \r\n
    <h2>Welche Beschwerden verursachen vergr&ouml;&szlig;erte H&auml;morrhoiden?</h2>\r\n
    \r\n
    <p>Typische Symptome bei vergr&ouml;&szlig;erten H&auml;morrhoiden sind Juckreiz, N&auml;ssen und Brennen am After. Oftmals bemerken Menschen mit einem H&auml;morrhoidalleiden auch hellrotes Blut im Stuhl. Blutungen geh&ouml;ren ebenfalls zu den h&auml;ufigen Symptomen bei vergr&ouml;&szlig;erten H&auml;morrhoiden. Schmerzen verursachen sie &uuml;blicherweise nicht. Wichtig: Wer bei sich erstmals Blut im Stuhl entdeckt, sollte das auf jeden Fall &auml;rztlich abkl&auml;ren lassen.</p>\r\n
    \r\n
    <p>Vergr&ouml;&szlig;erte H&auml;morrhoiden k&ouml;nnen zudem ein Druck- oder Fremdk&ouml;rpergef&uuml;hl im Analbereich verursachen, wodurch das Sitzen sehr unangenehm wird. Viele Patientinnen und Patienten berichten auch von dem Gef&uuml;hl, dass sich der Darm trotz Stuhlgang nur unvollst&auml;ndig entleert.</p>\r\n
    \r\n
    <p>In fortgeschrittenen Stadien treten die vergr&ouml;&szlig;erten H&auml;morrhoiden aus dem After heraus und werden als weiche Knoten sichtbar. In diesem Stadium k&ouml;nnen zus&auml;tzlich Schmerzen auftreten. Dann ist auch der unabsichtliche Abgang von Schleim oder Stuhl m&ouml;glich.<sup>1,2</sup></p>\r\n
    \r\n
    <h2>Wie kann man vergr&ouml;&szlig;erten H&auml;morrhoiden vorbeugen?</h2>\r\n
    \r\n
    <p>Die meisten Risikofaktoren, die die Entstehung eines H&auml;morrhoidalleidens beg&uuml;nstigen, sind beeinflussbar. Es gibt eine ganze Reihe von Tipps, mit denen der Entstehung eines H&auml;morrhoidalleidens oder einem R&uuml;ckfall nach erfolgreicher Behandlung vorgebeugt werden kann.</p>\r\n
    \r\n
    <ul>\r\n
    \t<li>langes Langes Sitzen vermeiden &ndash; zum Beispiel immer wieder Pausen bei der Schreibtischarbeit einlegen</li>\r\n
    \t<li>lange Lange Toilettensitzungen vermeiden &ndash; keine Zeitung lesen, was den Aufenthalt verl&auml;ngert</li>\r\n
    \t<li>(Starkes) Pressen w&auml;hrend desbeim Toilettengangs vermeiden</li>\r\n
    \t<li>bei Bei der Ern&auml;hrung auf ausreichend Ballaststoffe achten &ndash; etwa durch den Verzehr von Vollkornprodukten</li>\r\n
    \t<li>Ern&auml;hrung um Flohsamenschalen erg&auml;nzen &ndash; sie enthalten viele Ballaststoffe und k&ouml;nnen den Stuhlgang auf nat&uuml;rliche Weise regulieren</li>\r\n
    \t<li>ausreichend Ausreichend trinken (mindestens 1,5 Liter am Tag)</li>\r\n
    \t<li>Bewegung in den Alltag einbauen &ndash; zum Beispiel Treppen steigen, Besorgungen zu Fu&szlig; erledigen</li>\r\n
    \t<li>eventuelles&nbsp;&Uuml;bergewicht abbauen<sup>1,2</sup></li>\r\n
    </ul>\r\n
    \r\n
    <h2>Wie wird ein H&auml;morrhoidalleiden behandelt?</h2>\r\n
    \r\n
    <p>H&auml;morrhoidalleiden werden in 4 vier Krankheitsstadien eingeteilt. Die Behandlungsm&ouml;glichkeiten h&auml;ngen vom Stadium ab, das vor allem durch die Gr&ouml;&szlig;e der H&auml;morrhoiden und die St&auml;rke der Beschwerden bestimmt wird.</p>\r\n
    \r\n
    <h3>Stadium 1</h3>\r\n
    \r\n
    <p>Im Stadium 1 sind die vergr&ouml;&szlig;erten H&auml;morrhoiden von au&szlig;en noch nicht sichtbar und verursachen meist keine Beschwerden. In diesem fr&uuml;hen Stadium reichen in der Regel allgemeine Ma&szlig;nahmen aus. Die Patientinnen und Patienten sollen ihr Toilettenverhalten anpassen (nicht pressen!) und den Stuhl durch die ausreichende Aufnahme von Ballaststoffen und Fl&uuml;ssigkeit geschmeidig halten.</p>\r\n
    \r\n
    <p>Sie k&ouml;nnen sich zudem vonVom ihrem Arzt oder ihrer von der &Auml;rztin k&ouml;nnen sie sich zudem Salben oder Z&auml;pfchen verschreiben lassen, die die Beschwerden reduzieren. Reicht dies nicht aus, besteht die M&ouml;glichkeit, die H&auml;morrhoiden mit einer Ver&ouml;dungstherapie zu behandeln. Hierbei injiziert der Arzt oder die &Auml;rztin einen Wirkstoff, der die Durchblutung der H&auml;morrhoiden behindert.</p>\r\n
    \r\n
    <h3>Stadium 2</h3>\r\n
    \r\n
    <p>Auch im Stadium 2 sind die H&auml;morrhoiden noch nicht dauerhaft sichtbar. Sie sind jetzt aber gro&szlig; genug, dass sie bei der Darmentleerung kurzzeitig aus dem After heraustreten k&ouml;nnen. Sie ziehen sich jedoch von selbst wieder zur&uuml;ck. Bei einem H&auml;morrhoidalleiden im Stadium 2 wird den Patientinnen und Patienten zu den Basisma&szlig;nahmen aus Stadium 1 geraten, auch eine Ver&ouml;dungstherapie kann in diesem Stadium noch sehr erfolgreich sein. Dar&uuml;ber hinaus kommt eine sogenannte Gummibandligatur in Ffrage. Dabei bindet der Arzt oder die &Auml;rztin die H&auml;morrhoiden mit einem kleinen Gummiband ab, sodass sie nicht mehr durchblutet werden und nach einiger Zeit abfallen.</p>\r\n
    \r\n
    <h3>Stadium 3</h3>\r\n
    \r\n
    <p>Sind die H&auml;morrhoiden st&auml;ndig sicht- und tastbar, k&ouml;nnen aber noch zur&uuml;ckgedr&uuml;ckt werden, befindet sich das H&auml;morrhoidalleiden in Stadium 3. Auch in diesem Stadium kann eine Gummibandligatur helfen, die vergr&ouml;&szlig;erten H&auml;morrhoiden zu entfernen. Manchmal ist aber auch eine operative Behandlung notwendig. Dabei werden die vergr&ouml;&szlig;erten Gef&auml;&szlig;polster chirurgisch entfernt.</p>\r\n
    \r\n
    <h3>Stadium 4</h3>\r\n
    \r\n
    <p>Im Stadium 4 ragen die H&auml;morrhoiden dauerhaft aus dem Analkanal heraus und k&ouml;nnen auch nicht mehr in den After zur&uuml;ckgedr&uuml;ckt werden. In diesem Stadium bleibt nur die operative Entfernung der vergr&ouml;&szlig;erten H&auml;morrhoiden.<sup>1,2,3,4</sup></p>\r\n
    \r\n
    <p>&nbsp;</p>\r\n
    \r\n
    <p><strong>Quellen:</strong></p>\r\n
    \r\n
    <ol>\r\n
    \t<li>S3-Leitlinie &ndash; H&auml;morrhoidalleiden
https://register.awmf.org/assets/guidelines/081-007l_S3__H%C3%A4morrhoidalleiden_2019-07_01.pdf</li>\r\n
    \t<li>Bundesministerium f&uuml;r Gesundheit/gesund.bund.de
https://gesund.bund.de/haemorrhoiden</li>\r\n
    \t<li>Internisten im Netz: H&auml;morrhoiden
https://www.internisten-im-netz.de/krankheiten/haemorrhoiden/behandlung-bei-haemorrhoiden/</li>\r\n
    \t<li>Unabh&auml;ngige Patientenberatung Deutschland: Vergr&ouml;&szlig;erte H&auml;morrhoiden
https://www.patientenberatung.de/de/informationen/gesundheit/vergroesserte-haemorrhoiden</li>\r\n
    </ol>
    """
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    date: 2023-11-30 16:55:35.0 UTC (+00:00)
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:71
Show trace 
[
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:72
Show trace 
[
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:73
Show trace 
[
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Flashes

Flashes

Key Value
error 
[
  "Sie müssen eingeloggt sein um diesen Artikel lesen zu können!"
]

Server Parameters

Server Parameters

Defined in .env

Key Value
APP_ENV 
"dev"
APP_SECRET 
"a1d687c7188a8bbff1cb1e7504f8f22f"
DATABASE_URL 
"mysql://apofalk-academy:0az5otq1qeT1QVQK@127.0.0.1:3306/apofalk-academy"
MAILER_DSN 
"smtp://apofalk@creatediv-ld.de:39BaN2nuNswCGnS3@mail.your-server.de:587"
MAILER_NAME 
"apofalk.de"
MAILER_USER 
"info@creatediv.de"
MESSENGER_TRANSPORT_DSN 
"doctrine://default?auto_setup=0"
POINTS_FOR_ELEARNING 
"20"
POINTS_FOR_QUIZ 
"10"
POINTS_NEEDED_FOR_CLUB 
"60"
RECAPTCHA3_KEY 
"6Ldel2srAAAAAMErRmDfnJD44fJlQO7XiPCMCq6n"
RECAPTCHA3_SECRET 
"6Ldel2srAAAAAMTxiVbo9uLja-5gTMOyiwrsfvwo"
WKHTMLTOPDF_PATH 
"/usr/local/bin/wkhtmltopdf"

Defined as regular env variables

Key Value
APP_DEBUG 
"1"
CONTEXT_DOCUMENT_ROOT 
"/var/www/vhosts/apofalk-academy.dev-plesk.creatediv.local/httpdocs/htdocs/public"
CONTEXT_PREFIX 
""
DOCUMENT_ROOT 
"/var/www/vhosts/apofalk-academy.dev-plesk.creatediv.local/httpdocs/htdocs/public"
FCGI_ROLE 
"RESPONDER"
GATEWAY_INTERFACE 
"CGI/1.1"
HOME 
"/var/www/vhosts/apofalk-academy.dev-plesk.creatediv.local"
HTTPS 
"on"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
HTTP_CONNECTION 
"close"
HTTP_HOST 
"apofalk-academy.dev-plesk.creatediv.local"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
HTTP_X_ACCEL_INTERNAL 
"/internal-nginx-static-location"
HTTP_X_FORWARDED_FOR 
"216.73.216.53"
HTTP_X_FORWARDED_HOST 
"apofalk-academy.dev-creatediv.de"
HTTP_X_FORWARDED_SERVER 
"apofalk-academy.dev-creatediv.de"
HTTP_X_REAL_IP 
"192.168.20.3"
PATH 
"/usr/local/sbin:/usr/local/bin:/usr/sbin:/usr/bin:/sbin:/bin:/snap/bin"
PHP_SELF 
"/index.php"
QUERY_STRING 
""
REDIRECT_HTTPS 
"on"
REDIRECT_SCRIPT_URI 
"https://apofalk-academy.dev-plesk.creatediv.local/fachartikel/jucken-brennen-naessen-gegen-vergroeßerte-haemorrhoiden-laesst-sich-etwas-tun"
REDIRECT_SCRIPT_URL 
"/fachartikel/jucken-brennen-naessen-gegen-vergroeßerte-haemorrhoiden-laesst-sich-etwas-tun"
REDIRECT_SSL_TLS_SNI 
"apofalk-academy.dev-plesk.creatediv.local"
REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"aYnBM07YIWmOLmbRz8jsswAAAAI"
REDIRECT_URL 
"/fachartikel/jucken-brennen-naessen-gegen-vergroeßerte-haemorrhoiden-laesst-sich-etwas-tun"
REMOTE_ADDR 
"192.168.20.3"
REMOTE_PORT 
"46994"
REQUEST_METHOD 
"GET"
REQUEST_SCHEME 
"https"
REQUEST_TIME 
1770635571
REQUEST_TIME_FLOAT 
1770635571.9573
REQUEST_URI 
"/fachartikel/jucken-brennen-naessen-gegen-vergroe%C3%9Ferte-haemorrhoiden-laesst-sich-etwas-tun"
SCRIPT_FILENAME 
"/var/www/vhosts/apofalk-academy.dev-plesk.creatediv.local/httpdocs/htdocs/public/index.php"
SCRIPT_NAME 
"/index.php"
SCRIPT_URI 
"https://apofalk-academy.dev-plesk.creatediv.local/fachartikel/jucken-brennen-naessen-gegen-vergroeßerte-haemorrhoiden-laesst-sich-etwas-tun"
SCRIPT_URL 
"/fachartikel/jucken-brennen-naessen-gegen-vergroeßerte-haemorrhoiden-laesst-sich-etwas-tun"
SERVER_ADDR 
"192.168.20.6"
SERVER_ADMIN 
"[no address given]"
SERVER_NAME 
"apofalk-academy.dev-plesk.creatediv.local"
SERVER_PORT 
"443"
SERVER_PROTOCOL 
"HTTP/1.0"
SERVER_SIGNATURE 
"<address>Apache Server at apofalk-academy.dev-plesk.creatediv.local Port 443</address>\n"
SERVER_SOFTWARE 
"Apache"
SSL_TLS_SNI 
"apofalk-academy.dev-plesk.creatediv.local"
SYMFONY_DOTENV_VARS 
"APP_ENV,APP_SECRET,DATABASE_URL,MESSENGER_TRANSPORT_DSN,MAILER_DSN,MAILER_NAME,MAILER_USER,WKHTMLTOPDF_PATH,POINTS_NEEDED_FOR_CLUB,POINTS_FOR_QUIZ,POINTS_FOR_ELEARNING,RECAPTCHA3_KEY,RECAPTCHA3_SECRET"
UNIQUE_ID 
"aYnBM07YIWmOLmbRz8jsswAAAAI"
USER 
"sysuser_1"
proxy-nokeepalive 
"1"