What Are Hemorrhoids? Anatomy, Classification, Symptoms, and Diagnosis

Because of the natural aversion to the anus, patients and physicians often ascribe virtually any anorectal symptom to “hemorrhoids” without an adequate investigation of other potential causes. This practice may delay appropriate care for other benign anorectal diseases, or worse, delay treatment of a missed malignancy. However, many patients truly suffer from symptomatic hemorrhoids. Although hemorrhoids are normal anatomic structures, they may enlarge, prolapse, bleed, or thrombose. The diagnosis can be made by history, physical examination, anoscopy and/or proctoscopy. Internal hemorrhoids are classified by their degree of prolapse.