Internal Hemorrhoid

Etiology

  • Normal vascular cushions that help w/continence, cushioning

Risk Factors

  • Very common
  • Perhaps chronic straining
  • Industrialized societies

Symptoms

  • Itching
  • Soiling
  • Painless bleeding
  • Fullness/swelling sensation
  • Blood on toilet paper, in bowl
  • Rare site of variceal bleeding from portal htn

Physical Exam Findings

  • Blood apparent on digital rectal if bleeding at time of exam
  • Grade 1 not visible unless use anoscope
  • Grade 2 prolapse but reduces on own
  • Grade 3 prolapse and requires manual reduction
  • Grade 4 prolapse and can't be reduced

Links