Hemorrhoids classification: Difference between revisions

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Revision as of 15:40, 16 June 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Hemorrhoids can be classified according to their site into external and internal hemorrhoids.

External hemorrhoids are those that occur outside of the anal verge.
They are sometimes painful, and can be accompanied by swelling and irritation. Itching, although often thought to be a symptom from external hemorrhoids, is more commonly due to skin irritation.
External hemorrhoids are prone to thrombosis: if the vein ruptures and a blood clot develops, the hemorrhoid becomes a thrombosed hemorrhoid.^[1]

Internal hemorrhoids are those that occur inside the rectum.
As this area lacks pain receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them.
Internal hemorrhoids, however, may bleed when irritated.
Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids:

Furthermore, internal hemorrhoids can be graded according to severity into 4 grades. The most common grading system was developed by Banov:^[2]

- Grade I: The hemorrhoids do not prolapse.
- Grade II: The hemorrhoids prolapse upon defecation but spontaneously reduce.
- Grade III: The hemorrhoids prolapse upon defecation, but must be manually reduced.
- Grade IV: The hemorrhoids are prolapsed and cannot be manually reduced.

↑ E. Gojlan, Pathology, 2nd ed. Mosby Elsevier, Rapid Review series.
↑ name="pmid3861909">Banov L, Knoepp LF, Erdman LH, Alia RT (1985). "Management of hemorrhoidal disease". J S C Med Assoc. 81 (7): 398–401. PMID 3861909.

@@ Line 18: / Line 18: @@
 ====By degree of prolapse====
-Furthermore, prolapsed hemorrhoids can be graded according to severity into 4 grades. The most common grading system was developed by Banov:<ref name=". <ref> name="pmid3861909">{{cite journal |author=Banov L, Knoepp LF, Erdman LH, Alia RT |title=Management of hemorrhoidal disease |journal=J S C Med Assoc |volume=81 |issue=7 |pages=398–401 |year=1985 |pmid=3861909 |doi=}}</ref>
+Furthermore, internal hemorrhoids can be graded according to severity into 4 grades. The most common grading system was developed by Banov:<ref name=". <ref> name="pmid3861909">{{cite journal |author=Banov L, Knoepp LF, Erdman LH, Alia RT |title=Management of hemorrhoidal disease |journal=J S C Med Assoc |volume=81 |issue=7 |pages=398–401 |year=1985 |pmid=3861909 |doi=}}</ref>
-* '''Grading of Internal Hemorrhoids'''
 ** '''Grade I:''' The hemorrhoids do not prolapse.
 ** '''Grade II:''' The hemorrhoids prolapse upon defecation but spontaneously reduce.