Once hemorrhoidal symptoms develop, a variety of treatment options exist, depending upon the situation and severity of the hemorrhoids. Internal hemorrhoids are graded by the degree of prolapse below the pectinate line into the anal canal.
Grade 1: The internal hemorrhoid bulges into the canal but does not prolapse or fall completely into it. These may bleed.
Grade 2: The hemorrhoid protrudes past the anal verge with straining for a bowel movement or passage of flatus, but spontaneously returns to its original internal position once the straining has subsided.
Grade 3: The hemorrhoid may protrude past the anal verge without any straining and requires the patient to push them inside manually.
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