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*External hemorrhoids | *External hemorrhoids occur below the dentate line. | ||
* | *External hemorrhoids are sometimes painful and can be accompanied by [[swelling]] and [[irritation]]. | ||
*[[Itching]], although often thought to be a symptom of external hemorrhoids, is more commonly due to skin [[irritation]]. | *[[Itching]], although often thought to be a symptom of 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 | *External hemorrhoids are prone to [[thrombosis]]; if the [[vein]] ruptures and a [[blood clot]] develops, the hemorrhoids become [[thrombosed]].<ref>E. Gojlan, ''Pathology, 2nd ed.'' Mosby Elsevier, Rapid Review series.</ref> | ||
===Internal hemorrhoids=== | ===Internal hemorrhoids=== | ||
*Internal hemorrhoids are those that occur above the dentate line. | *Internal hemorrhoids are those that occur above the dentate line. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Hemorrhoids can be classified according to their location as external or internal hemorrhoids. Furthermore, internal hemorrhoids can be graded according to severity into 4 grades.
Classification
Hemorrhoids can be classified according to their location as external or internal hemorrhoids.[1]
External hemorrhoids
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- External hemorrhoids occur below the dentate line.
- External hemorrhoids are sometimes painful and can be accompanied by swelling and irritation.
- Itching, although often thought to be a symptom of 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 hemorrhoids become thrombosed.[2]
Internal hemorrhoids
- Internal hemorrhoids are those that occur above the dentate line.
- 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.
By degree of prolapse
Furthermore, internal hemorrhoids can be graded according to severity into 4 grades. The most common grading system was developed by Banov:[3]
- 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.
References
- ↑ Rivadeneira DE, Steele SR, Ternent C, Chalasani S, Buie WD, Rafferty JL (2011). "Practice parameters for the management of hemorrhoids (revised 2010)". Dis. Colon Rectum. 54 (9): 1059–64. doi:10.1097/DCR.0b013e318225513d. PMID 21825884.
- ↑ 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.