Table 3: Differentiating features on endoscopy between hemorrhoids and rectal varices.

Rectal varicesHemorrhoids

Extend superior to levator aniExtension above levator ani not seen

Usually originate more than 4 cm above anal verge, distinct from hemorrhoidsUsually originated less than 4 cm below level of anal verge

Not contiguous with anal column or pectinate lineMaybe contiguous

Dilated, tortuous, submucosal vein, 3 to 6 mm in diameter and dark blue in colorLess dilated, nontortuous, paler, smaller in size

Do not prolapse into the proctoscope during examinationProlapse into proctoscope commonly seen with higher grade