Straining That Returns Inside in Surgery — 42yo Man | General Surgery | SMLE Q#1403
SMLE Question #1403
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 42-year-old man has 6 months of intermittent, painless, bright red rectal bleeding on toilet paper. He reports anal fullness during defecation and a protruding mass with straining that returns inside on its own after defecation. He denies severe anal pain, weight loss, or fecal incontinence. Anoscopy shows internal hemorrhoids that prolapse with straining and spontaneously reduce. What is the grade of his hemorrhoids?
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