<prompt> Which of the following is true about hemorrhoids?Hemorrhoids diagnosed by DREExternal hemorrhoids are proximal to dentate lineInternal hemorrhoids bleed profusely and painlessInternal hemorrhoids are covered by anoderm  <response>: Hemorrhoids- Are Normal anatomical cushions- Made of Venules Aerioles Smooth muscle fibers Elastic tissuesLocation of hemorrhoids- 3 o clock- 7O clock- 110 clockPathophysiology- On constipation due to Excessive straining Abnormal descent of anatomical cushions Injury by hard fecal matter Bleeding PR Mc cause of bleeding PR - Hemorrhoids Mc cause of significant lower GI bleed - Colonic diveicula Mc cause of occult lower GI bleed - Angiodysplasia Vascular ectasia Clinical Presentation- Painless bleeding- Amount of bleeding - 3 to 5 ml to a max of 10 mlDiagnosis- They Cannot be palpated, therefore hemorrhoids cannot be diagnosed by DRE- Diagnosis of hemorrhoids - by proctoscopy Internal Hemorrhoids External Hemorrhoids - Location - above dentate line Pain insensitive region- Painless bleeding- Treatment - depends on the degree - Location - below dentate linepain sensitive region- Painful bleeding- Aka 5- days painful self-curing lesion- Recurrent thrombosis in externalhemorrhoids leads to semi- RIPE blackcurrant- Treatment - Excision 