The Difference Between Internal and External Hemorrhoids

The Difference Between Internal and External Hemorrhoids

Most people do not realize that there are actually two types of hemorrhoids. Hemorrhoids can exist on the outside of your anus (which is what most people think about when they hear the word “hemorrhoids”), but you can develop them inside of your anus as well. Both may have similar symptoms and can exist at the same time, but they can have different conditions.

The two types of hemorrhoids are referred to as external and internal hemorrhoids. At HD Treatment Center, we want to make sure that our customers know the true differences of the internal and external hemorrhoids and what to do if you have developed either one.

External Hemorrhoids

External hemorrhoids are visible, which makes them much easier to diagnose and ultimately  to treat. They reside on the outside of the anus, around the anus itself in the soft tissue. External hemorrhoids occurs when the soft tissue gets filled with blood due to the vessels in the tissue, causing the bumps, or hemorrhoids, to appear.


There are many different symptoms of external hemorrhoids, including finding bright red blood spots on your toilet paper and feeling pain when you sit down. You may find that the area itches and that it is raw when you are wiping after a bowel movement.

Internal Hemorrhoids

Internal hemorrhoids are located so deep inside the lining of the rectum that they oftentimes cannot be felt. They are usually painless and make their presence known by causing bleeding with a bowel movement. Internal hemorrhoids can obtrude or stick out through the anus.


Internal hemorrhoids may cause red blood to appear on the toilet paper when you are wiping, but you may also find blood on the stool. This is often a cause for alarm, but the majority of the time, it is due to internal hemorrhoids. If you notice these symptoms, it is important to contact your primary care provider right away. You may also have an itching in the anus area, and can also have what many sufferers call a “throbbing ache” in the area.

Prolapsed Hemorrhoids

Prolapsed hemorrhoids are internal hemorrhoids that periodically protrude from the anus. They are typically in stage III and stage IV. Prolapsed hemorrhoids come and go or remain protruding which is very painful.


Prolapsed hemorrhoid symptoms may include mild itching or burning, slight to temperate bleeding or in more extreme cases, produce severe pain by virtue of its becoming an inflamed mass of externalized tissue.  Other common prolapsed hemorrhoid symptoms include either red blood in the stool or residual red blood on toilet paper, or an inability to complete a bowel movement.  It should be noted that blackened stool or actual pain caused by the act of defecating is not typically symptomatic of a hemorrhoidal condition.


The treatment differs for internal and external hemorrhoids. Hemorrhoid treatment for someone who has external hemorrhoids can often be something as simple as taking sitz baths, where you sit in water up to your hips in a tub, and using medicated creams or pads on the affected area.

If you have internal hemorrhoids, however, your options change, as there are not any creams on the market that can help treat internal hemorrhoids. If you feel that you have internal hemorrhoids, it is a good idea to speak with your physician.

If you have hemorrhoids and are not sure if you have internal or external hemorrhoids, it is a good idea to speak with your doctor. Your physician will be able to give you the best treatment option for your condition. If you have any questions, call the HD Treatment Center today at (919) 861-9777.

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