1)First-degree hemorrhoids (grade I): The anal cushions bleed but do not prolapse; 2) Second-degree hemorrhoids (grade II): The anal cushions prolapse through the anus on straining but reduce spontaneously; 3) Third-degree hemorrhoids (grade III): The anal cushions prolapse through the anus on straining or exertion and require manual replacement into the anal canal; and 4) Fourth-degree hemorrhoids (grade IV): The prolapse stays out at all times and is irreducible