Types of Hemorrhoids:

Internal and External Hemorrhoids

Broadly speaking, there are two types of hemorrhoids (often called “piles“): internal hemorrhoids, those that occur inside the lower rectum above the dentate line, and external hemorrhoids, those that occur below the dentate line and are often observed as external lumps or bulges around the anus. However, external hemorrhoid-like symptoms are often actually caused by internal hemorrhoids.

Here are the key differences and similarities between the two types of hemorrhoids:

Internal hemorrhoids

Because they are inside the lower rectum, internal hemorrhoids often can’t be seen and are typically painless. Often, the only symptoms you may notice are itching, small amounts of bright red blood (on your toilet paper or inside the toilet bowl), or a feeling of fullness following a bowel movement.

However, internal hemorrhoids can also push through the anal opening. These are known as prolapsing hemorrhoids. Sometimes these hemorrhoids reduce (go back inside) spontaneously, and other times they must be manually reduced (pushed back in). This can lead to enlarged external hemorrhoids, and the development of excess skin (skin tags). In the vast majority of cases, treating the internal hemorrhoids will relieve the external symptoms. You may also want to have the skin tag removed, but it’s not necessary for recovery. 

External hemorrhoids

External hemorrhoids often occur as bulges or lumps around the anus. Because of the sensitive nerve fibers in this area, these abnormal vessels are often painful, especially when sitting. They also may bleed and itch. Should blood pool in an external hemorrhoid, a blood clot referred to as a thrombosed hemorrhoid may develop and cause severe pain.

If you think you have external hemorrhoids, be sure to see a doctor. Many people mistake external skin tags or irritation caused by internal hemorrhoids as an external hemorrhoid. In fact, around 90% of patients who complain about external issues are actually helped by hemorrhoidal banding of their internal hemorrhoids.

Whichever type of hemorrhoid you have, you should always consult with a doctor for accurate diagnosis, and to get any recommended screening for more serious issues such as colorectal or colon cancer. To find a hemorrhoid physician in your area, contact CRH today.