Severe hemorrhoids include grade III and IV circumferential internal hemorrhoids and grade III and IV circumferential mixed hemorrhoids (varicose veins or dermatoglyphic type). Clinical presentation Etiology: A history of chronic internal or mixed hemorrhoids. Common triggers are exertion, spicy diet and increased abdominal pressure such as constipation, diarrhea, long distance walking, carrying heavy loads, coughing, sneezing and squatting. Symptoms: blood in the stool, prolapse of the mass, pain, itching, weakness in defecation, difficulty in passing stool, and other symptoms. Signs: Perianal external hemorrhoids show varicose veins or skin bulges, internal hemorrhoid nuclei and rectal mucosa prolapse, swelling and congestion, which may be accompanied by thrombosis, partial mucosal necrosis, erosion, bleeding, and infection. Even the nucleus of hemorrhoid is ulcerated, swollen and painful, overflowing with pus, perianal eczema, etc. Treatment principles It is necessary to treat severe hemorrhoids, but also to protect the anal cushion tissue; to relieve other complications, but also to achieve the effect of orthopedic leveling. Therefore, the principle of individualized comprehensive treatment is generally advocated, with the aim of achieving reasonable design, simultaneous surgery, avoiding postoperative complications, improving near and long-term efficacy, and reducing the recurrence rate. Treatment 1. General treatment, bed rest in lateral position, maintain anal hygiene. 2, diet, it is appropriate to eat light food: fresh vegetables, fruits, etc.; avoid spicy, fatty products, avoid overeating, quit smoking and alcohol. 3, symptomatic support treatment. 4, the application of antibiotics.