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Clinical findings :

Symptoms :
1. Bleeding – streeking of faeces or passage of few drops post defecation
2. Pruritis –due to continuous perianal moisture
3. Discomfort – edema of heamorrhoids which may be severe if thrombosis recurs.

Prolapse :

1) This occurs initially after defaection

Spontaneously reduces to the stage of
3) Permanent non reduceable prolapse.

Work up:
Anoscopic examination: for heamorrhoids that do not protrude

Procto sigmoidoscopic examination: to exclude inflammatory or malignant disease at a higher level especially for patients above the age of 40.

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