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How Do You Know What Stage Your Hemorrhoid Is?

Posted on June 13, 2025

At the Texas Hemorrhoid Institute, we provide minimally invasive treatments for Grade 2-3 internal hemorrhoids. But how do you know what stage your hemorrhoid is at, in order to determine your best treatment options? In this post, we break down the hemorrhoid grading system to help you understand your treatment options.

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How Do You Know What Stage Your Hemorrhoid Is?

Internal hemorrhoids are classified on a grading system of 1 – 4, based on their level of prolapse from the anus.

  • Grade 1 Hemorrhoids: These swollen vessels may protrude into your anal canal, but they will not prolapse out of your anus.
  • Grade 2 Hemorrhoids: Hemorrhoids will prolapse when you strain or pass a bowel movement, but they will return into your anal canal without assistance.
  • Grade 3 Hemorrhoids:  Protrusion occurs with straining or when passing a bowel movement, but return only happens with manual repositioning.  
  • Grade 4 Hemorrhoids:  The hemorrhoid remains prolapsed outside of the anus.

Can Hemorrhoids Go Away On Their Own?

Grade 1 hemorrhoids may resolve without treatment, especially if you follow a diet to help hemorrhoids or make other lifestyle modifications.  Grade 2 hemorrhoids may shrink without a medical procedure, but Grade 3 hemorrhoids will not self-resolve and Grade 4 hemorrhoids must be treated surgically. As such, it’s important to speak to your doctor as soon as you notice symptoms such as itching, prolapsing or bleeding when you pass a bowel movement. When you receive a diagnosis at an earlier grade of prolapse, you will be able to find relief with less invasive treatment options.

How Do You Know What Stage Your Hemorrhoid is in Need of Treatment?

While rarely dangerous, untreated hemorrhoids can cause intrusive symptoms that interfere with your quality of life. For that reason, seeking early treatment is the best way to prevent progression and protect your health. Ready to find relief from bulging, itchy and uncomfortable hemorrhoids? We’re here to help. [Tx-appt-link] Reach out to our team [/tx-appt-link] to request a consultation at one of our seven Texas Hemorrhoid Institute locations.

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