Usually, external hemorrhoids appear as a painful lump around the anus. This is because a blood clot has formed in the hemorrhoid. It can be uncomfortable, but it only bleeds if the clot opens and drains.
Internal hemorrhoids, on the other hand, commonly produce bleeding. Blood may appear on toilet paper, in the toilet bowl or on the surface of the stool. Sometimes mucus is also seen on toilet paper or stool. Internal hemorrhoids are sometimes painful if they extend outside the anus, or if the blood vessels are clotted (called thrombosed hemorrhoids).
- First degree: the hemorrhoids remain inside at all times
- Second degree: the hemorrhoids extend out of the rectum during a bowel movement but return on their own
- Third degree: the hemorrhoids extend out during a bowel movement but can be pushed back inside
- Fourth degree: the hemorrhoid is always outside
Causes and Risk Factors
Constipation, diarrhea or straining when going to the bathroom can cause hemorrhoids.