The reason for black and purple hemorrhoids should be four stages, black and purple is because the nucleus of the hemorrhoid is embedded outside the anus resulting in insufficient blood supply, which causes the nucleus of the hemorrhoid to appear black and purple, which means necrosis. The hemorrhoids can be divided into four stages according to the size of the nucleus and whether it is protruding or not: stage 1 is bleeding from the anus after defecation without a lump; stage 2 is bleeding from the anus with a lump, but it can be returned to the anus by itself; stage 3 is bleeding from the anus with a lump and it needs to be returned to the anus by hand; stage 4 is bleeding from the anus with a lump protruding and it cannot be returned by itself or it is returned and then protrudes again If the hemorrhoid is embedded, it also belongs to stage IV. For stage IV hemorrhoids, surgery is recommended to remove it.