What are third degree internal hemorrhoids? How to identify the extent of internal hemorrhoids?

Internal hemorrhoids are one of the common anorectal diseases. They have the highest incidence among the three major types of hemorrhoids and are extremely common in clinical practice. So how do you identify the extent of internal hemorrhoids?

1. Three types of classification

Vascular edema type: caused by proliferation and expansion of capillaries, shaped like bayberry, with a rough or shiny surface, bright red in color, thin mucosa, soft to touch and easy to bleed.

Varicose aneurysm type: The venous plexus is tortuous, and there may be blood clots and varicose aneurysms that expand into spherical shapes in the hemorrhoids. The surface mucosa is thick and shiny, purple-red in color, and not easy to bleed.

Fibromatous type: Due to repeated prolapse, abrasion and inflammatory stimulation, the connective tissue of the internal hemorrhoids proliferates, and the surface mucosa becomes fibrotic and hard and elastic, pale in color, and not easy to bleed.

2.3 Phase Classification

Stage 1: Most patients have no obvious pain, but have a slight itching in the anus. They feel that there is more anal secretion, and occasionally the toilet paper is stained with blood, dripping blood or spurting blood after defecation.

Stage II: More severe than stage I, with larger hemorrhoids and weak hemorrhoidal mucosal tissue. When straining during bowel movements, the hemorrhoids may fall out of the anus and return to the anus on their own after defecation. During defecation, feces rub against the surface of the hemorrhoidal mucosa, causing blood in the stool. The blood in the stool may appear on toilet paper, drip, or spurt.

Stage III: It is the late stage of internal hemorrhoids. Due to the long-term internal hemorrhoids, the hemorrhoids have enlarged and may protrude from the anus after defecation, or even when coughing, exerting force, walking or working. They must be pushed back into the anus by hand or after a rest.

Three, four-phase classification

① Stage I internal hemorrhoids: There is blood or dripping blood or spurting bleeding during bowel movements, but there is no prolapse of the internal hemorrhoids, and the bleeding stops on its own after bowel movements.

② Stage II internal hemorrhoids: bleeding, dripping blood or spurting bleeding during bowel movements, accompanied by prolapse of internal hemorrhoids, which can retract on their own after bowel movements.

③ Stage III internal hemorrhoids: blood or blood dripping during bowel movements, accompanied by prolapse of internal hemorrhoids, or prolapse of internal hemorrhoids when standing for a long time, coughing, fatigue, or carrying weight, and must be manually reduced.

④ Stage IV internal hemorrhoids: internal hemorrhoids prolapse and cannot be retracted, and internal hemorrhoids may be accompanied by strangulation and incarceration.