+ Internal hemorrhoid grades Grade Diagram Picture 1 140px Endoscopic view 2 140px 140px 3 140px 140px 4 140px 140px Hemorrhoids are typically diagnosed by physical examination. A visual examination of the anus and surrounding area may diagnose external or prolapsed hemorrhoids. A rectal exam may be performed to detect possible rectal tumors, polyps, an enlarged prostate, or abscesses. This examination may not be possible without appropriate sedation because of pain, although most internal hemorrhoids are not associated with pain. Visual confirmation of internal hemorrhoids may require anoscopy, insertion of a hollow tube device with a light attached at one end. The two types of hemorrhoids are external and internal. These are differentiated by their position with respect to the pectinate line. Some persons may concurrently have symptomatic versions of both. If pain is present, the condition is more likely to be an anal fissure or an external hemorrhoid rather than an internal hemorrhoid. Internal Internal hemorrhoids originate above the pectinate line. They are covered by columnar epithelium, which lacks pain receptors. They were classified in 1985 into four grades based on the degree of prolapse: * Grade I: No prolapse, just prominent blood vessels * Grade II: Prolapse upon bearing down, but spontaneous reduction * Grade III: Prolapse upon bearing down requiring manual reduction * Grade IV: Prolapse with inability to be manually reduced. External thrombosed external hemorrhoid External hemorrhoids occur below the dentate (or pectinate) line. They are covered proximally by anoderm and distally by skin, both of which are sensitive to pain and temperature. Differential Many anorectal problems, including fissures, fistulae, abscesses, colorectal cancer, rectal varices, and itching have similar symptoms and may be incorrectly referred to as hemorrhoids. Rectal bleeding may also occur owing to colorectal cancer, colitis including inflammatory bowel disease, diverticular disease, and angiodysplasia. If anemia is present, other potential causes should be considered. Other conditions that produce an anal mass include skin tags, anal warts, rectal prolapse, polyps, and enlarged anal papillae. Anorectal varices due to portal hypertension (blood pressure in the portal venous system) may present similar to hemorrhoids but are a different condition. Portal hypertension does not increase the risk of hemorrhoids.
complications of Constipation
medical cause of Constipation
symptom of Stomach cancer
symptom of Irritable bowel syndrome
symptom of Hirschsprung's disease
symptoms of Short bowel syndrome
symptom of Necrotizing enterocolitis
symptom of Small intestine cancer