The guidelines for the management of hemorrhoids from the ASCRS classify internal hemorrhoids into four grades for the purposes of treatment recommendations:
Grade I: prominent hemorrhoidal vessels, no prolapse
Grade II: hemorrhoids that prolapse with Valsalva maneuver and spontaneously reduce
Grade III: hemorrhoids that prolapse with Valsalva maneuver and require manual reduction
Grade IV: chronically prolapsed hemorrhoids; manual reduction ineffective
Learn more about grading hemorrhoids.
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Cite this: B.S. Anand. Fast Five Quiz: Hemorrhoids Practice Essentials - Medscape - Apr 18, 2022.