Hemorrhoids(Piles) it’s classification, clinical features, investigations, management and Homoeopathic Treatment (Part 2)

Classification depending upon the location of hemorrhoids:-
(1)Internal hemorrhoids:-internal hemorrhoids locate above the dentate line, covered with mucous membrane. Internal hemorrhoids usually present with painless, bright red rectal bleeding during or following a bowel movement. The blood typically covers the stool is on the toilet paper or drips into the toilet bowl.
(2) External hemorrhoids:- External hemorrhoids locate at anal verge, covered with skin. If external hemorrhoids not thromboses, external hemorrhoids may cause few problems. However, when thromboses, hemorrhoids may be very painful. If hemorrhoids are large & cause issues with hygiene, they may produce irritation of the surrounding skin & thus itchiness around the anus.
(3) Intern-external:-both varieties together. Location:- Classically situated in the 3,7,11 O’clock positions(left lateral, right posterior & right anterior respectively.
Grades with clinical features:-
(1) Grade1:-Here painless bleeding occurs. After defecation fresh bleeding occurs-Splash in the Pan. This causes chronic anemia. Hemorrhoids which bleed are called Grade1 hemorrhoids. (2)The capillaries of the lamina prairie are only protected by a single layer of epithelial cells. So, minor trauma at this part precipitates bleeding.
(3)Grade2:– As the straining increases, the hemorrhoids partly prolapsed outside. After defecation, it returns back again. It is Grade 2 hemorrhoids. (4) Grade3 hemorrhoids:- After defecation, it may returns back or can be digitally replaced. It is Grade 3 hemorrhoids
(5) Grade4:-In this case permanently prolapsed pile outside. The patient complains of pain or discomfort.
(6) Most of the patients usual complain is constipation.
Grade features with symptoms:-(1)Never prolapsed:-Bleeding per rectum (2) Prolapsed on defecation & spontaneous reduction:- Something coming down & going back (3) Prolapsed on defecation require manual reduction:- Something coming down, bleeding, mucus discharge, purities.
(4)Permanent prolapsed:-Acute pain, throbbing discomfort.

(Next part about investigation, complications,