Internal hemorrhoids do not necessarily require surgery, but are treated in different ways depending on the severity of the condition. Clinically, internal hemorrhoids are usually divided into four stages, with stage one being the least severe and stage four being the most severe. Stage I internal hemorrhoids only show blood in the stool, and the amount of blood in the stool is not much, often dripping blood or blood on the paper towel; Stage II internal hemorrhoids have blood in the stool, but it increases significantly, often showing jet-like bleeding; Stage III internal hemorrhoids also have blood in the stool along with the prolapse of the anal mass during defecation, and the prolapsed mass can be retracted into the anus after defecation; Stage IV internal hemorrhoids have the most serious condition, with blood in the stool along with the prolapse of the anal mass, and the prolapsed mass cannot be retracted after defecation. The most serious condition of stage IV internal hemorrhoids is blood in the stool with the prolapsed swelling in the anus, and the prolapsed swelling cannot be retracted after defecation, resulting in local edema and severe pain. If the hemorrhoid comes out of the anus and causes severe pain around the anus, you need to go to the hospital immediately for surgery, if you delay the surgery, it will lead to local ischemic necrosis.