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Hemorrhoids: Clinical manifestations and diagnosis

Ronald Bleday, MD
Elizabeth Breen, MD
Section Editor
J Thomas Lamont, MD
Deputy Editor
Shilpa Grover, MD, MPH


The cardinal features of hemorrhoidal disease include bleeding, anal pruritus, prolapse, and pain due to thrombosis. This topic will review the anatomic classification, clinical manifestations, and diagnosis of hemorrhoids. The medical and surgical management of hemorrhoids are discussed in detail, separately. (See "Treatment of hemorrhoids" and "Surgical treatment of hemorrhoidal disease".)


Hemorrhoids are normal vascular structures in the anal canal, arising from a channel of arteriovenous connective tissues that drains into the superior and inferior hemorrhoidal veins

External hemorrhoids are located distal to the dentate line

Internal hemorrhoids are located proximal to the dentate line

Mixed hemorrhoids are located both proximal and distal to the dentate line


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Literature review current through: Sep 2016. | This topic last updated: Aug 15, 2016.
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