There are two types of Hemorrhoids based on their location:
External hemorrhoids develop near the anal opening which is covered by
sensitive skin. A patient suffering from external hemorrhoids experiences
a hard, sensitive lump that bleeds on rupture.
Internal hemorrhoids develop inside the anal canal. One of the common
symptoms of this type of hemorrhoid is painless bleeding and protrusion
of hemorrhoids from the anal canal during bowel movement. Internal hemorrhoids
are painful if it is prolapsed- if the hemorrhoid protrudes
from the anal opening and cannot be pushed back (1) & (4).
The severity of internal
hemorrhoids can be described through a grading system as follows:
First-degree hemorrhoids: Hemorrhoids that bleed
but do not protrude from the anus (i.e., do not prolapse).
Second-degree hemorrhoids: In this subtype, the
hemorrhoid protrudes from the anus during bowel movement and retracts
on its own into the anal canal later.
Third-degree hemorrhoids: In this subtype, a
hemorrhoid protrudes from the anus during the bowel movement,
but does not retract on its own and is required to be pushed in
with a finger.
Fourth-degree hemorrhoids: Hemorrhoids protrude or
prolapse from the anus and cannot be pushed back into the anal canal
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