Grading of Internal Hemorrhoids (Piles)

Internal hemorrhoids can be graded based on the extent of prolapse through the anal sphincter.

Bulge into Lumen	Prolapse Through Anal Sphincter	Reducibility	Grade (Degree)
no	NA	NA	0
yes	no	NA	1
yes	during defecation	returns spontaneously	2
yes	remain prolapsed	can be manually pushed back	3
yes	remain prolapsed, longstanding	cannot be manually pushed back	4

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