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Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Goligher's classification of internal hemorrhoids provides a systematic way to assess the severity of hemorrhoids based on physical examination findings. This classification helps determine the appropriate treatment strategy by assigning a grade from I to IV.

To use this assessment, consider the following physical findings and corresponding interpretations:

- Prominent hemorrhoidal vessels, no prolapse: This description indicates Grade I hemorrhoids where vessels are noticeable but do not prolapse.
- Prolapse with Valsalva, spontaneous reduction: This finding corresponds to Grade II, where hemorrhoids prolapse during a Valsalva maneuver (like straining) but reduce on their own.
- Prolapse with Valsalva, requires manual reduction: Grade III captures hemorrhoids that need manual assistance to reduce after prolapsing during a Valsalva maneuver.
- Chronically prolapsed, manual reduction ineffective: This scenario describes Grade IV hemorrhoids, which are constantly prolapsed and cannot be reduced manually.

Upon examining these physical findings, a practitioner can assign the appropriate grade to the hemorrhoids:

- If the finding matches "Prominent hemorrhoidal vessels, no prolapse," you classify it as Grade I.
- If the observation is "Prolapse with Valsalva, spontaneous reduction," assign Grade II.
- When the finding is "Prolapse with Valsalva, requires manual reduction," it corresponds to Grade III.
- If the condition is "Chronically prolapsed, manual reduction ineffective," classify it as Grade IV.

This structured approach allows healthcare providers to efficiently classify hemorrhoids, guiding the appropriate management or intervention based on established clinical standards.

The calculator in question is Goligher's classification of internal hemorrhoids. This classification system is used specifically in patients who have been diagnosed with internal hemorrhoids. The clinical utility of this calculator is to categorize the severity of internal hemorrhoids into four grades based on their characteristics and symptoms. This helps clinicians to decide the most appropriate treatment strategy for the patient.

Grade I hemorrhoids are small and remain inside the anal canal. Grade II hemorrhoids are larger and may protrude during bowel movements but retract spontaneously. Grade III hemorrhoids protrude during bowel movements and must be manually reduced. Grade IV hemorrhoids are permanently prolapsed and cannot be reduced.

There are no specific exclusion criteria for the use of Goligher's classification, but it is only applicable to internal hemorrhoids and not to external hemorrhoids or other anorectal conditions.

Goligher's classification of internal hemorrhoids

Hemorrhoids

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Updated 2024 ASCRS guidelines for the diagnosis and management of hemorrhoids


Updated 2024 LHP-RDG guidelines for laser hemorrhoidoplasty in symptomatic hemorrhoids


Hemorrhoids

Guidelines

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