The clinical grading of hemorrhoids is for internal hemorrhoids, and its grading determines the patient’s treatment plan. There are four degrees of hemorrhoids: 1. degree I: blood in the stool, dripping blood or jet bleeding, bleeding can stop on its own after the stool, no hemorrhoid nucleus prolapse. 2.Degree II: There is often blood in the stool, and the hemorrhoid is prolapsed during defecation, and can be returned after the stool by itself. 3.Degree III: Occasional blood in stool, hemorrhoid prolapses when defecating or standing for a long time, coughing, exertion, weight-bearing, and needs to be retracted by hand. 4.Degree IV: Occasional blood in the stool, the nucleus of the hemorrhoid can not be returned after prolapse, or it can be returned and then prolapse again. What are the symptoms of hemorrhoids: The symptoms of hemorrhoids vary according to their clinical type. The main symptoms of internal hemorrhoids are bleeding and prolapse, and painless intermittent bleeding after stool is a common symptom of internal hemorrhoids; external hemorrhoids mainly present with anal discomfort, dampness and uncleanness, sometimes with itching; patients with mixed hemorrhoids can present with both internal and external hemorrhoids. How to diagnose hemorrhoids: The diagnosis of hemorrhoids mainly relies on anorectal examination, including anal visual examination, rectal finger examination and anoscopy. Most hemorrhoids are visible during anal visual examination, and if they prolapse, it is best to observe them immediately after a squatting bowel movement; rectal finger examination is mainly used to rule out other lesions in the rectum, such as rectal cancer and rectal polyps. If the diagnosis is still difficult, anoscopy can be used. The diagnosis of hemorrhoids needs to be differentiated from rectal cancer, rectal polyps, rectal prolapse, anal fissure and other diseases, among which the differentiation from rectal cancer is very important. There are often clinical cases where rectal cancer is misdiagnosed as hemorrhoids and treatment is delayed, mainly because the diagnosis is based on symptoms and stool tests only, without anal finger examination and proctoscopy, and most low rectal cancers can be detected through rectal finger examination. Therefore, when diagnosing hemorrhoids, we must pay attention to the differentiation from rectal cancer and pay attention to the role of rectal finger examination. Patients with rectal cancer have a change in stool shape and can find uneven hard lumps during rectal finger examination, while hemorrhoids are dark red round soft vascular masses, mostly seen as blood in the stool. If it is still difficult to differentiate, proctoscopy is recommended. In patients with rectal cancer, a cancerous mass or ulcerated surface can be seen microscopically, which is hard, bleeds easily when touched and has uneven edges. Microscopic tissue sampling for pathological examination is the gold standard for differentiating hemorrhoids from rectal cancer.