Appendix 1 Main Symptoms and Accessory Symptoms Scoring

Symptoms	score
pain	0 : None
	1 : Sometimes during a bowel movement
	2 : Every time during a bowel movement
	3 : Always with moderate pain
	4 : Always with severe pain
bleeding	0 : None
	1 : Blood on the toilet paper sometimes
	2 : Blood on the toilet paper ever time
	3 : Pink water in the toilet bowl
	4 : Bleeding from the bottom during a bowel movement or anytime
prolapse	0 : None
	1 : No prolapse with rectal tenesmus
	2 : Prolapse upon bearing down, but spontaneous reduction
	3 : Prolapse upon bearing down requiring manual reduction
	4 : Prolapse with inability to be manually reduced
itching	0 : None
	1 : Sometimes
	2 : Always
discharge	0 : None
	1 : Sometimes
	2 : Always

Total symptom score = (pain score × 1.0) + (bleeding score × 1,0) + (prolapse score × 1.5)
Main symptoms(pain, bleeding, prolapse), Accessory symptoms(itching, discharge)