Pathophysiology Hemorrhoids result from activities that increase intravenous pressure, causing distention and engorgement.

Predisposing factors include prolonged sitting, straining at defecation, constipation, low-fiber diet, pregnancy, and obesity. Other factors include hepatic disease, such as cirrhosis, amebic abscesses, or hepatitis; alcoholism; and anorectal infections.Hemorrhoids are classified as first, second, third, or fourth degree, depending on their severity. First-degree hemorrhoids are confined to the anal canal. Second-degree hemorrhoids prolapse during straining but reduce spontaneously. Third-degree hemorrhoids are prolapsed hemorrhoids that require manual reduction after each bowel movement. Fourth-degree hemorrhoids are irreducible. Signs and symptoms vary accordingly.