Clinical practice. Hemorrhoids.

@article{Jacobs2014ClinicalPH,
  title={Clinical practice. Hemorrhoids.},
  author={Danny O. Jacobs},
  journal={The New England journal of medicine},
  year={2014},
  volume={371 10},
  pages={944-51}
}
An audio version of this article is available at NEJM.org An otherwise healthy 50-year-old woman presents with painless rectal bleeding; she occasionally sees small amounts of red blood on the toilet paper immediately after defecation and in the toilet water. She also has constipation and intermittent perianal itching with a sense of swelling and aching discomfort around the anal orifice. How should her case be evaluated and managed? 
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