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Abstract Hemorrhoids are cushions of arteriovenous vascular plexuses that surround the distal rectum and anal canal. It is present in all individuals from birth and become symptomatic when enlarged, intlammed, thrombosed, or prolapsed. It is defined as internal or external based on whether they are located above or below the dentate line. Internal hemorrhoids are redundant portions of mucous membrane of anal canal above dentate line, lined by columnar epithelium. If they are large enough, they can protrude into the anal canal and emerge at the anal verge. The most common symptoms of hemorrhoids are bleeding and prolapse, and it is graded accordingly using the Goligher system into: Grade 1, hemorrhoids with bleeding; Grade 2, hemorrhoids with bleeding and protrusion, with spontaneous reduction; Grade 3, hemorrhoids with bleeding and protrusion that require manual reduction; and Grade 4, prolapsed hemorrhoids that cannot be replaced. |