Medical Classifications
of Hemorrhoid
The following are descriptions of four stages of hemorrhoids:
Stages 0-2 are non-prolapsing hemorrhoids.
Stage 0
Morphology: Anal cushion
Symptoms:Very rare bleeding, no prolapse
Additional features: None
Visual: No increase
Age Group (years): All ages, <20 if
symptomatic
Treatment: Change in bowel habit &
diet, sclerotherapy / infrared coagulation for stubborn
cases
Stage 1
Morphology: Small hemorrhoids
Symptoms: Intermittent bleeding, no prolapse
Additional features: None, with exception
of some pain
Visual: Minor, but definite increase as
can be observed by proctoscopy
Age Group (years): 20 - 45
Treatment: Sclerotherapy & Infrared
coagulation. Rubber band ligation & surgery for certain
cases.
Stage 2
Morphology: Intermediate hemorrhoids
Symptoms: Prolapse during straining but
spontaneously return; frequent bleeding, sometimes profusely
Additional features: Anal itching (pruritus
ani), and sometimes skin tags
Visual: Moderate increase of individual
masses that prolapse during straining
Age Group (years): >30
Treatment: Rubber band ligation & stapling.
Surgery in some cases.
Stage 3 & 4 are prolapsing hemorrhoids.
Stage 3
Morphology: Large hemorrhoids
Symptoms: Prolapse, need manual aid to
put back in anal canal, bleed frequently & often profusely.
Additional features: Anal itching (pruritus
ani), discomfort, skin tags
Visual: Major increase in size, prolapse
Age Group (years): > 40
Treatment: Hemorrhoidectomy
Stage 4
Morphology: Very large hemorrhoids
Symptoms: Permanent prolapse, bleed profusely,
blood stains on underwear even without bowel movement
Additional features: Severe pain, anal
itching, severe discomfort, soilings, skin tags
Visual: Extreme increase in size, visible
skin tags, secondary hemorrhoids may develop
Age Group (years): > 50
Treatment: Hemorrhoidectomy, sometimes
with anoplasty
|
