Hemorrhoids classification: Difference between revisions

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


====By degree of prolapse====
====By degree of prolapse====

Revision as of 20:53, 26 July 2017

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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 site into external and internal hemorrhoids. Furthermore, internal hemorrhoids can be graded according to severity into 4 grades.

Classification

Hemorrhoids can be classified according to their site into external and internal hemorrhoids.[1]

External hemorrhoids

By BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=27924388
By BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=27924388
  • External hemorrhoids are those that occur below the dentate line.
  • 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.[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

  1. 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.
  2. E. Gojlan, Pathology, 2nd ed. Mosby Elsevier, Rapid Review series.
  3. 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.

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