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학습 자료 둘러보기 →The dentate line divides the anal canal. External hemorrhoids originate below this line, are covered by sensitive anoderm, and typically present with pain and a visible, palpable swelling at the anal opening.
In contrast, internal hemorrhoids arise above the dentate line under visceral innervation. The classic presentation is painless, bright red bleeding that may drip into the toilet or appear on toilet paper.
Never assume all rectal bleeding is from hemorrhoids. Painless hematochezia can mimic colorectal neoplasms. A thorough history, digital rectal exam, and possible colonoscopy referral are essential, especially in clients over 45-50 years.
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