Hemorrhoids are classified as internal, external, or mixed hemorrhoids. Internal hemorrhoids are pathologic changes and/or abnormal displacement of the vascular cushion of the anal canal. External hemorrhoids are pathological dilatation and thrombosis of the subepidermal venous plexus of the inferior rectal vein distal to the dentate line. Mixed hemorrhoids are the fusion of the internal venous plexus with the external venous plexus in the corresponding area. The main clinical manifestations are blood in the stool, prolapse, anal discomfort and pain. Blood in the stool: The early manifestation of internal hemorrhoids is blood in the stool, mostly blood in the stool paper handkerchief or dripping blood, bright red blood and small amount. As the volume of hemorrhoid nucleus increases and the symptoms worsen, it can be shown as dripping or shooting blood with bright red color and more volume, which can reach tens of milliliters at a time when it is serious. Repeated heavy bleeding can cause hemorrhagic anemia. External hemorrhoids usually do not bleed, but they can bleed when the skin is broken or the thrombus is ulcerated. Prolapse: The internal hemorrhoid of degree II or above can be separated from the muscle layer and prolapse out of the anus due to the increase of the volume of the nucleus and the impact and extrusion of the feces during defecation. Initially, the hemorrhoid only comes out during defecation and can be reset by itself after defecation. Later on, the nucleus cannot be returned by itself and needs to be rested by hand or after rest. In the later stage, because of anal relaxation, the hemorrhoid nucleus can be prolapsed when exerting force, walking, coughing, sneezing, squatting or not concentrating, or even when the nucleus is prolapsed outside the anus for a long time. If the hemorrhoid nucleus is repeatedly prolapsed, the mucous membrane is easily damaged and inflamed, congested, edematous and eroded, and if it is not reset in time, it can become embedded and difficult to reset. Pain: Internal hemorrhoids are usually painless, but when they are embedded or have thrombosis, they can cause severe pain. Thrombosed external hemorrhoids and inflammatory external hemorrhoids show severe pain, which is aggravated when defecating or moving. Superfluous external hemorrhoids and varicose external hemorrhoids are generally painless. Protruding masses: Superfluous external hemorrhoids present as soft skin pendulousness of varying size at the anal verge, or in severe cases as a ring-like protrusion. Thrombosed external hemorrhoids and inflammatory external hemorrhoids present as sudden painful masses at the anal verge. Varicose external hemorrhoids present with soft lumps at the anal verge after defecation or when straining or squatting. Anal discomfort: connective tissue external hemorrhoids, varicose veins external hemorrhoids local bulge, irritate the perianal area; crease increase, not easy to clean after stool, all can lead to anal discomfort. Anal swelling: All stages of internal hemorrhoids can have different degrees of anal swelling and a feeling of incomplete defecation, which is heavier in the late stage and is due to the stimulation of the rectal mucosa by the hypertrophic hemorrhoid nucleus, or mucosal congestion and edema. Dampness and itching: internal hemorrhoids prolapse, mucous membrane inflammation and erosion, increasing exudate; or anal relaxation, intestinal fluid overflow, causing anal dampness and itching. External hemorrhoids affect the local cleaning of the anus can also lead to anal itching. Long-term bad stimulation makes the anal skin hyperplasia and moss-like changes. The treatment of hemorrhoids (a) Treatment principles: Asymptomatic hemorrhoids do not require treatment. The aim of treatment of symptomatic hemorrhoids is to eliminate and reduce the main symptoms of hemorrhoids, not to cure them. General treatment is necessary for all types of hemorrhoids. Non-surgical treatment is mainly applicable to I and II degree internal hemorrhoids. Surgical treatment is mainly applicable to III and IV degree internal hemorrhoids, mixed hemorrhoids and those where non-surgical treatment including external hemorrhoid thrombosis is ineffective. Surgical treatment should pay attention to avoid postoperative complications. (2) General treatment: including drinking more water, eating more dietary fiber, keeping the bowels open, preventing constipation and diarrhea, taking warm sitz baths, keeping the perineum clean, etc. (C) Conservative treatment: Chinese herbal medicine and topical suppositories and ointments. (4) Surgical treatment: mainly traditional external stripping and internal ligation and TST (minimally invasive), each with its own advantages and disadvantages.