Are Yours Internal or External?

Internal hemorrhoids lie far enough inside the rectum that you can’t see or feel them. They don’t usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign they’re there.

Sometimes internal hemorrhoids “prolapse,” or enlarge and protrude outside the anal sphincter. When this happens, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed hemorrhoids may hurt because the anus is dense with pain-sensing nerves.

External hemorrhoids lie within the anus. They’re usually painful. If they move, or prolapse, to the outside (usually when you have a bowel movement), you can see and feel it.

Blood clots sometimes form within prolapsed external hemorrhoids, causing a very painful condition called a thrombosis. If that happens, the hemorrhoid can turn purple or blue, and could possibly bleed. Despite its appearance, it’s usually not serious, apart from the pain. It will go away in a couple of weeks. Your doctor can remove it if the pain is unbearable.

You should get any anal bleeding and pain checked by a doctor to make sure it’s not a more serious condition. Hemorrhoids are the No. 1 cause of this type of bleeding and are rarely dangerous, but you should find out for sure.