How are internal hemorrhoids graded, particularly grade I?

Internal hemorrhoids are graded based on their degree of prolapse. For grade I hemorrhoids, the defining characteristic is that they do not prolapse beyond the anal canal; they remain internally situated. This is important for understanding both the clinical presentation and management of hemorrhoids.

Grade I hemorrhoids may still cause symptoms such as bleeding, but they do not protrude through the anal opening, which distinguishes them from higher-grade hemorrhoids that do prolapse and may require intervention. Recognizing that grade I hemorrhoids do not prolapse is crucial for diagnosing and determining the appropriate treatment and monitoring strategy, as they often do not prompt the immediate surgical interventions that more severe grades might indicate.