Internal Hemorrhoids - Classification Grade l: • 1st-degree or primary hemorrhoids - normal or near-normal • Prominent vasculature with engorgement, but no prolapse Grade II: • 2nd-degree or secondary hemorrhoids - some symptoms • Hemorrhoidal tissue prolapses only with straining but spontaneously reduces Grade Ill: • 3rd-degree or tertiary hemorrhoids Hemorrhoidal tissue prolapses beyond the dentate line with straining and can only be reduced manually • Itching, staining from mucous discharge, soilage, and swelling may occur Grade IV: • 4th-degree or quaternary hemorrhoids • Prolapsed tissues are evident that cannot be reduced manually • Chronic inflammatory changes with maceration, mucosal atrophy, friability, and ulceration are commonly observed Dr. Enrik Aguila @enrrikke #Internal #Hemorrhoids #Classification #grading #grades #diagnosis
