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Hemorrhoid Classification

Hemorrhoids are broadly categorized as Internal or External.

Internal hemorrhoids are those that originate inside the body above the dentate line (in the lower rectum).

The dentate line is simply where the internal mucus membrane joins with a more skin-like surface leading to the exterior of the body.

Internal hemorrhoids are further classified by clinicians as follows:

Grade 1	The hemorrhoids remain completely inside the body, although symptoms such as bleeding may persist.
Grade 2	The hemorrhoids are usually inside the body but are pushed out (they "prolapse") during defecation and they return inside the body (they "reduce") on their own.
Grade 3	The hemorrhoids are inside the body but are pushed out (they "prolapse") during defecation. They do not return inside the body ('"reduce") on their own. They can return inside the body only by manually pushing them in.
Grade 4	The hemorrhoids originate from inside the body but they are always outside of the body - they are permanently prolapsed and cannot be manually pushed back inside.

External hemorrhoids are those that originate outside the body as shown in the diagram above. These are not classified any further.

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