Hemorrhoids are generally divided into four stages, especially stage four internal hemorrhoids, which are generally hemorrhoids that prolapse out of the anus and cannot be retracted. Because the anal opening is relatively small, contraction of the anal sphincter can lead to poor reflux of the hemorrhoidal veins, which can lead to edema if the blockage is prolonged, and if the hemorrhoidal veins do not reflux well it can lead to local bruising, which can form a thrombus and cause local pain. If the stasis is longer, it can lead to local ischemia and necrosis, which can lead to impaction and, in severe cases, strangulation and finally necrosis. Therefore, stage IV hemorrhoids are very serious. If you have stage IV hemorrhoids, you should promptly undergo surgical treatment, such as anal dilation, external and internal ligation of mixed hemorrhoids, to first remove the formed thrombus, then perform anal massage, and give post-operative anti-inflammatory, hemostatic and swelling treatment.