Hemorrhoids are mainly divided into internal, external and mixed hemorrhoids, as follows:
(1) Internal hemorrhoids are divided into four stages:
Hemorrhoids in the first stage: blood in the stool, red blood. Under the microscope, the lower end of the rectal mucosa showed nodules, red in color and soft in quality.
Hemorrhoids in the second stage: blood in the stool, bright red in color, prolapsed from the anus during the stool, and can be repaid by itself after the stool. Under the microscope, the mucosa thickened, and the hemispherical bulge was purple-red.
Hemorrhoids in the third stage: The tumor prolapses during the stool and cannot be repaid by itself. It needs to be pushed back by hand or reset after lying supine. It can even come out when exerting force, coughing, walking, squatting.
Incarcerated internal hemorrhoids: If the hemorrhoids are prolapsed and cannot be sent back in time, due to sphincter spasm, blood reflux is blocked, hemorrhoids are congested and edema, thrombosis, pain is severe, restless, there are secretions on the surface, and even surface ulceration and necrosis. This is an acute attack of internal hemorrhoids, called incarcerated internal hemorrhoids or internal hemorrhoids incarcerated.
(2) There are four types of external hemorrhoids:
External connective tissue hemorrhoids: also known as external epidermal hemorrhoids. It is formed by the hyperplasia of connective tissue at the anal margin, manifested by enlarged skin folds, hemorrhoids have no varicose vein plexus, yellow-brown or dark-brown, and vary in size. The patient has a foreign body sensation or anal discomfort, and it is difficult to clean after going to the toilet.
Varicose external hemorrhoids: It is formed by the varicose vein plexus outside the hemorrhoids, forming a round, oval soft mass on the anal margin, which is obvious when squatting and defecation. Generally asymptomatic. In severe cases, there may be anal bulging or foreign body sensation. It is often corresponding to female hemorrhoids, and often occurs in the second and third stages of hemorrhoids and mixed hemorrhoids.
Inflammatory external hemorrhoids: sudden localized lumps on the anal margin, congestion, edema, and severe pain.
Thrombotic external hemorrhoids: The lining of the hemorrhoidal veins is inflamed and damaged, and blood accumulates in the blood vessels to form thrombus. It manifests as a sudden round or oval mass on the anal margin, severe pain, aggravated by activities.
(3) Mixed hemorrhoids: Mixed hemorrhoids have the characteristics of internal hemorrhoids and external hemorrhoids, that is, the venous plexus of the internal hemorrhoids merges with the venous plexus of the external hemorrhoids in the same direction, and the tooth line disappears. Mixed hemorrhoids can be single or circular. The clinical treatment of circular mixed hemorrhoids is more difficult.