Зображення 01249. Grade IV haemorrhoids

A 65-year-old woman had felt her haemorrhoids bulging during several months. There was no rectal bleeding. The patient had felt pain for a couple of weeks but not anymore at the time of examination. The haemorrhoids were soft but not reducible. The condition is classified as the late stage of grade IV haemorrhoids. If the patient in this situation has the patience to just wait, the swelling will probably resolve with time and the external bulbs remain. If the patient is not able to cope with the haemorrhoids, conventional surgical excision is the best treatment. Rubber band ligation is not sufficient here because the external parts of the haemorrhoids cannot be removed with this technique.