Internal hemorrhoid - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T23:13:26Z

Prepared the page for translation

← Revisión anterior		Revisión del 23:13 4 ene 2026
Línea 1:		Línea 1:
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	==Background==		==Background==

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	{{Hemorrhoid background}}		{{Hemorrhoid background}}
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	==Clinical Features==		==Clinical Features==

	*Occur proximal to dentate line		*Occur proximal to dentate line
	*Constant in their location: 2-, 5-, and 9-o'clock positions (when patient viewed prone)		*Constant in their location: 2-, 5-, and 9-o'clock positions (when patient viewed prone)
	*Not readily palpable; best visualized through [[anoscope]]		*Not readily palpable; best visualized through [[Special:MyLanguage/anoscope\|anoscope]]
	**May be palpable when prolapsed or thrombosed		**May be palpable when prolapsed or thrombosed
	*Painless [[rectal bleeding\|bleeding]]		*Painless [[Special:MyLanguage/rectal bleeding\|bleeding]]
	**Only painful when nonreducible, strangulation of prolapsed hemorrhoid, or thrombosis (these can lead to infection/necrosis)		**Only painful when nonreducible, strangulation of prolapsed hemorrhoid, or thrombosis (these can lead to infection/necrosis)


	==Differential Diagnosis==		==Differential Diagnosis==

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	{{Anorectal DDX}}		{{Anorectal DDX}}
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	{{Lower GI bleeding DDX}}		{{Lower GI bleeding DDX}}
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	==Evaluation==		==Evaluation==

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	{{Internal Hemorrhoid Chart}}		{{Internal Hemorrhoid Chart}}
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	==Management==		==Management==

	*Conservative treatment		*Conservative treatment
	**Indicated for mild to moderate symptomatic patients with grade 1 to grade 3 hemorrhoids		**Indicated for mild to moderate symptomatic patients with grade 1 to grade 3 hemorrhoids
	**Stool softeners ([[psyllium]]), high-fiber diet, topical analgesics		**Stool softeners ([[Special:MyLanguage/psyllium\|psyllium]]), high-fiber diet, topical analgesics
	**Avoid [[laxatives]] causing liquid stool (can lead to [[cryptitis]] and anal [[sepsis]])		**Avoid [[Special:MyLanguage/laxatives\|laxatives]] causing liquid stool (can lead to [[Special:MyLanguage/cryptitis\|cryptitis]] and anal [[Special:MyLanguage/sepsis\|sepsis]])
	**Sitz bath 15min TID and after each bowel movement (decreases sphincter pressure)		**Sitz bath 15min TID and after each bowel movement (decreases sphincter pressure)
	**Outpatient surgical referral		**Outpatient surgical referral
Línea 30:		Línea 50:
	**Incarceration and/or strangulation (grade 4 hemorrhoids)		**Incarceration and/or strangulation (grade 4 hemorrhoids)
	**Intractable pain		**Intractable pain


	===Prolapse===		===Prolapse===

	*When prolapse occurs may develop mucous discharge and pruritus ani		*When prolapse occurs may develop mucous discharge and pruritus ani
	**If prolapse cannot be reduced progressive edema and strangulation may result		**If prolapse cannot be reduced progressive edema and strangulation may result
	**Other complications: severe bleeding, thrombosis, infarction, gangrene, sepsis		**Other complications: severe bleeding, thrombosis, infarction, gangrene, sepsis


	==Disposition==		==Disposition==

	*Generally may be discharged (unless need for surgical intervention)		*Generally may be discharged (unless need for surgical intervention)


	==See Also==		==See Also==
	*[[Anorectal Disorders]]
	*[[Hemorrhoids]]		*[[Special:MyLanguage/Anorectal Disorders\|Anorectal Disorders]]
			*[[Special:MyLanguage/Hemorrhoids\|Hemorrhoids]]


	==External Links==		==External Links==


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
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Blsimpso: /* Clinical Features */

2021-08-18T18:29:03Z

Clinical Features

← Revisión anterior		Revisión del 18:29 18 ago 2021
Línea 5:		Línea 5:
	*Occur proximal to dentate line		*Occur proximal to dentate line
	*Constant in their location: 2-, 5-, and 9-o'clock positions (when patient viewed prone)		*Constant in their location: 2-, 5-, and 9-o'clock positions (when patient viewed prone)
	*Not readily palpable; best visualized through anoscope		*Not readily palpable; best visualized through [[anoscope]]
	**May be palpable when prolapsed or thrombosed		**May be palpable when prolapsed or thrombosed
	*Painless [[rectal bleeding\|bleeding]]		*Painless [[rectal bleeding\|bleeding]]

ClaireLewis at 21:43, 29 September 2019

2019-09-29T21:43:08Z

← Revisión anterior		Revisión del 21:43 29 sep 2019
Línea 7:		Línea 7:
	*Not readily palpable; best visualized through anoscope		*Not readily palpable; best visualized through anoscope
	**May be palpable when prolapsed or thrombosed		**May be palpable when prolapsed or thrombosed
	*Painless bleeding		*Painless [[rectal bleeding\|bleeding]]
	**Only painful when nonreducible, strangulation of prolapsed hemorrhoid, or thrombosis (these can lead to infection/necrosis)		**Only painful when nonreducible, strangulation of prolapsed hemorrhoid, or thrombosis (these can lead to infection/necrosis)

Línea 21:		Línea 21:
	*Conservative treatment		*Conservative treatment
	**Indicated for mild to moderate symptomatic patients with grade 1 to grade 3 hemorrhoids		**Indicated for mild to moderate symptomatic patients with grade 1 to grade 3 hemorrhoids
	**Stool softeners (psyllium), high-fiber diet, topical analgesics		**Stool softeners ([[psyllium]]), high-fiber diet, topical analgesics
	**Avoid laxatives causing liquid stool (can lead to cryptitis and anal sepsis)		**Avoid [[laxatives]] causing liquid stool (can lead to [[cryptitis]] and anal [[sepsis]])
	**Sitz bath 15min TID and after each bowel movement (decreases sphincter pressure)		**Sitz bath 15min TID and after each bowel movement (decreases sphincter pressure)
	**Outpatient surgical referral		**Outpatient surgical referral

Rossdonaldson1: /* See Also */

2017-02-15T11:21:37Z

Rossdonaldson1: /* Evaluation */

2017-02-15T11:18:13Z

Evaluation

← Revisión anterior		Revisión del 11:18 15 feb 2017
Línea 16:		Línea 16:

	==Evaluation==		==Evaluation==
	~~===Classification===~~
	*'''Grade I''': Luminal protrusion above dentate line; no prolapse; painless bleeding
	*'''Grade II''': Prolapse with spontaneous reduction; prolapse during straining
	*'''Grade III''': Prolapse requires manual reduction; prolapse during straining
	*'''Grade IV''': Prolapse—nonreducible; can result in edema and strangulation

	{{Internal Hemorrhoid Chart}}		{{Internal Hemorrhoid Chart}}

Rossdonaldson1 at 11:13, 15 February 2017

2017-02-15T11:13:20Z

← Revisión anterior		Revisión del 11:13 15 feb 2017
Línea 22:		Línea 22:
	*'''Grade IV''': Prolapse—nonreducible; can result in edema and strangulation		*'''Grade IV''': Prolapse—nonreducible; can result in edema and strangulation

	{~~\| class="wikitable" style="float: right; margin-left:15px; text-align:center"~~		{{Internal Hemorrhoid Chart}}
	\|+ Internal ~~hemorrhoid grades~~
	~~!Grade !! Diagram !! Picture~~
	\|-
	~~\|1\|\| [[File:Piles Grade 1.svg\|140px]] \|\| [[File:Haemorrhoiden 1Grad endo 01.jpg\|140px\|Endoscopic view]]~~
	\|-
	~~\|2\|\| [[File:Piles Grade 2.svg\|140px]]\|\|[[File:Hemrrhoids 04.jpg\|140px]]~~
	\|-
	~~\|3\|\| [[File:Piles Grade 3.svg\|140px]]\|\|[[File:Hemrrhoids 05.jpg\|140px]]~~
	\|-
	~~\|4\|\| [[File:Piles Grade 4.svg\|140px]]\|\|[[File:Piles 4th deg 01.jpg\|140px]]~~
	\|}

	==Management==		==Management==

Rossdonaldson1: /* Evaluation */

2017-02-15T11:06:30Z

Evaluation

@@ Línea 21: / Línea 21: @@
 *'''Grade III''': Prolapse requires manual reduction; prolapse during straining
 *'''Grade IV''': Prolapse—nonreducible; can result in edema and strangulation
 ==Management==

Mholtz at 05:55, 12 February 2017

2017-02-12T05:55:41Z

← Revisión anterior		Revisión del 05:55 12 feb 2017
Línea 1:		Línea 1:
	==Background==		==Background==
	{{~~Hemorroids~~ background}}		{{Hemorrhoid background}}

	==Clinical Features==		==Clinical Features==

Mholtz at 05:51, 12 February 2017

2017-02-12T05:51:36Z

← Revisión anterior		Revisión del 05:51 12 feb 2017
Línea 8:		Línea 8:
	**May be palpable when prolapsed or thrombosed		**May be palpable when prolapsed or thrombosed
	*Painless bleeding		*Painless bleeding
	**Only painful when nonreducible, prolapsed ~~hemorrhoids strangulate OR thrombose~~		**Only painful when nonreducible, strangulation of prolapsed hemorrhoid, or thrombosis (these can lead to infection/necrosis)
	***Can lead to infection/necrosis

	==Differential Diagnosis==		==Differential Diagnosis==
Línea 18:		Línea 17:
	==Evaluation==		==Evaluation==
	===Classification===		===Classification===
	*Grade I: Luminal protrusion above dentate line; no prolapse; painless bleeding		*'''Grade I''': Luminal protrusion above dentate line; no prolapse; painless bleeding
	*Grade II: Prolapse with spontaneous reduction; prolapse during straining		*'''Grade II''': Prolapse with spontaneous reduction; prolapse during straining
	*Grade III: Prolapse requires manual reduction; prolapse during straining		*'''Grade III''': Prolapse requires manual reduction; prolapse during straining
	*Grade IV: Prolapse—nonreducible; can result in edema and strangulation		*'''Grade IV''': Prolapse—nonreducible; can result in edema and strangulation

	==Management==		==Management==
Línea 42:		Línea 41:

	==Disposition==		==Disposition==
	*~~Usually outpatient~~		*Generally may be discharged (unless need for surgical intervention)

	==See Also==		==See Also==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T06:14:05Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 06:14 22 jul 2016
Línea 16:		Línea 16:
	{{Lower GI bleeding DDX}}		{{Lower GI bleeding DDX}}

	==~~Diagnosis~~==		==Evaluation==
	===Classification===		===Classification===
	*Grade I: Luminal protrusion above dentate line; no prolapse; painless bleeding		*Grade I: Luminal protrusion above dentate line; no prolapse; painless bleeding

← Revisión anterior		Revisión del 11:21 15 feb 2017
Línea 41:		Línea 41:
	==See Also==		==See Also==
	*[[Anorectal Disorders]]		*[[Anorectal Disorders]]
			*[[Hemorrhoids]]

	==External Links==		==External Links==