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Classification of haemorrhoids

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Haemorrhoids may be either:

  • internal:
    • with an origin above the dentate line
    • are generally painless unless they become strangulated

  • external:
    • with an origin below the dentate line
    • are generally painful as they are covered by sensate skin

Haemorrhoids may be of four grades:

  • grade I:
    • do not prolapse out of the anal canal

  • grade II:
    • prolapse on defecation but reduce spontaneously on cessation of straining

  • grade III:
    • require manual reduction to reduce fully

  • grade IV:
    • cannot be reduced manually

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