Hemorrhoids

Background

  • Pathologic state cccurs when internal or external hemorrhoid plexus become engorged, prolapsed, or thrombosed
  • Bleeding is usually limited (surface of stool, on toilet tissue, at end of defecation)
    • Passage of blood clots requires evaluation for colon lesions

Risk Factors

  • Constipation and straining at stool
  • Frequent diarrhea
  • Older age
  • IBD

Types

Internal hemorrhoid chart

Internal hemorrhoid grades
GradeDescriptionDiagramPicture
I
  • Luminal protrusion above dentate line
  • No prolapse
  • Painless bleeding
II
  • Prolapse with spontaneous reduction
  • Prolapse during straining
III
  • Prolapse requires manual reduction
  • Prolapse during straining
IV
  • Prolapseā€”nonreducible
  • Can result in edema and strangulation

See Also

References

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