Haemorrhoids and Military Service: Prolapse Grade Decides

The short answer: haemorrhoids prevent conscription or not depending on the grade of node prolapse. Article 46 of the Schedule of Diseases is unusually simple: grade II–III prolapse on its own places the case in clause «b» and yields category V — no anaemia and no complications are needed. Single small nodes without flares, by contrast, are excluded by the regulation in plain words.

Which fitness category haemorrhoids yield

Note that «a» and «b» give a conscript the same category — V. There is no need to argue about anaemia if the required grade of prolapse is documented.

Frequent complications and secondary anaemia: the numbers

The regulation sets this as a number, not a judgement:

Frequent complications of haemorrhoids are cases where the person assessed receives inpatient treatment 3 or more times a year for bleeding, thrombosis or prolapse of grade II–III haemorrhoidal nodes, and also where the disease is complicated by repeated bleeding requiring inpatient treatment.

Two independent routes: three or more admissions a year, or repeated bleeding that required inpatient care. Flares treated at home do not enter that count.

Secondary anaemia is the other half of clause «a» and is confirmed by a blood test. What a low haemoglobin means and how it is assessed is covered in the piece on iron deficiency anaemia.

When the article does not apply at all

An important proviso that ends the hope of "but I do have haemorrhoids":

The presence of single, slightly enlarged haemorrhoidal nodes without signs of inflammation, in the absence of complaints and with no history of exacerbation over the past 3 years, is not grounds for applying this article, does not prevent military service and does not prevent admission to military educational institutions.

Three conditions at once: the nodes are single and only slightly enlarged, there is no inflammation or complaint, and there were no flares in three years. Where all three coincide, article 46 simply does not apply.

Refusing treatment: what follows

The regulation covers this too:

Where indicated, persons assessed under columns I, II and III of the schedule of diseases are offered surgical or conservative treatment. In the event of unsatisfactory treatment results or refusal of treatment, assessment is carried out under clauses «a» and «b» or «v» depending on the severity of secondary anaemia and the frequency of complications.

Refusing the offered treatment therefore does not remove you from the article and does not automatically worsen your position: assessment still follows the actual picture — prolapse grade, complication frequency and anaemia.

Proctologist report and what your records must contain

• A proctologist's conclusion stating the grade of prolapse — the grade specifically, not merely "haemorrhoids".
• Anoscopy or sigmoidoscopy with a description of the findings.
• Discharge summaries with dates: for clause «a» their number per year matters.
• A full blood count with haemoglobin — to confirm secondary anaemia.
• A three-year history of flares — it determines whether the article applies at all.
• The chart code is K64; it records haemorrhoids but not the grade of prolapse.

What is usually missing

• The conclusion says "haemorrhoids" but does not state the grade of prolapse.
• Flares were treated at home with no admissions — while clause «a» counts inpatient cases.
• No blood count was taken, so secondary anaemia cannot be confirmed; what to do about low haemoglobin is covered separately.
• There is no record of flares over the past three years — and then the exclusion clause applies.
• The examination was long ago and no longer reflects the current picture.

Questions for your doctor

• What grade of haemorrhoidal node prolapse is recorded for me?
• How many admissions were there in the past year, and for what?
• Are there signs of secondary anaemia in my blood count?
• Were there flares in the past three years, and are they in the chart?
• Was treatment offered, and what was the result?

Haemorrhoids at departmental boards

The above concerns assessment under Government Decree No. 565. The Interior Ministry, National Guard, Federal Security Service and Emergencies Ministry use their own schedules of diseases with their own requirements. A review under article 46 shows how complete your records are but is not their regulation.

The short version

Haemorrhoids are the rare case where one characteristic decides almost everything: grade II–III prolapse yields category V regardless of complications or anaemia. Everything else concerns admission frequency and the blood picture. But if the nodes are single, uninflamed and there have been no flares for three years, the article does not apply at all. The key things in the records are therefore a recorded grade and a dated history. Only the military medical board determines the fitness category.