Which of the following statements about hemorrhoids is/are not true?

C. Pain is often associated with uncomplicated hemorrhoids.

DISCUSSION: Hemorrhoids are specialized, highly vascularized cushions in the anal canal that aid continence. The cause of hemorrhoids is unknown, but they may represent nothing more than the downward sliding of anal cushions associated with straining and irregular bowel habits. They are classified and treated according to the severity of symptoms. External hemorrhoids are covered with anoderm and are distal to the dentate line. Internal hemorrhoids are covered by the mucosal lining of the anal canal proximal to the dentate line. They can cause painless bleeding, usually in association with defecation. Uncomplicated hemorrhoids usually are not associated with pain, but fissures more often are. Hemorrhoidectomy is reserved for third-degree (bleeding with prolapse requiring manual reduction) and fourth-degree (permanently prolapsed with or without bleeding) hemorrhoids.