Internal and external hemorrhoids

Both pages sort hemorrhoids by place. ahem has not examined anyone and does not sell a treatment. A swollen vein and a small tear are a different comparison, on hemorrhoids and anal fissures.

Mayo Clinic dates its symptoms page August 23, 2025. Opened October 30, 2026, it calls hemorrhoids swollen veins in the anus and lower rectum, like varicose veins. Hemorrhoids that develop inside the rectum are internal. Hemorrhoids that develop under the skin around the anus are external. The overview line says internal hemorrhoids are usually painless but tend to bleed, and external hemorrhoids may cause pain.

NIDDK last reviewed its symptoms page in October 2016. Opened the same day, it says the symptoms depend on the type. It does not open with a one-sentence location definition. The lists below are how it separates the two.

NIDDK's internal list, opened October 30, 2026, is bleeding from the rectum, described as bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement, and a hemorrhoid that has fallen through the anal opening, which it calls prolapse. Internal hemorrhoids that are not prolapsed most often are not painful. Prolapsed internal hemorrhoids may cause pain and discomfort.

Mayo Clinic's internal section says these hemorrhoids lie inside the rectum. A person usually cannot see or feel them, and they rarely cause discomfort. Straining or irritation when passing stool can cause painless bleeding, which it describes as small amounts of bright red blood on toilet tissue or in the toilet, and a hemorrhoid that pushes through the anal opening. It calls that a prolapsed or protruding hemorrhoid, and says it may result in pain and irritation.

The grade names for prolapse, from no prolapse through a hemorrhoid that will not stay in, are on internal hemorrhoid grades. How a prolapsed hemorrhoid differs from the rectum itself slipping out is on a prolapsed hemorrhoid and rectal prolapse.

NIDDK's external list, opened October 30, 2026, is:

• Anal itching.
• One or more hard, tender lumps near the anus.
• Anal ache or pain, especially when sitting.

NIDDK adds that too much straining, rubbing, or cleaning around the anus may make symptoms worse, and that for many people the symptoms of external hemorrhoids go away within a few days. That few-days line, and Mayo Clinic's separate week of home care, are on how long hemorrhoid symptoms usually last.

Mayo Clinic's external list is itching or irritation in the anal area, pain or discomfort, swelling around the anus, and bleeding. Bleeding is on Mayo Clinic's external list. It is not on NIDDK's external list. NIDDK places bright red bleeding in the internal section. This page does not move bleeding from one list to the other.

Mayo Clinic describes a thrombosed hemorrhoid as blood that pools in an external hemorrhoid and forms a clot. On the page dated August 23, 2025 and opened October 30, 2026, that can mean severe pain, swelling, inflammation, and a hard, discolored lump near the anus. NIDDK's symptom list names a hard, tender lump and pain, and it does not use the word thrombus on this page.

Mayo Clinic's complications section says a clot can be extremely painful and sometimes needs to be drained, and that it calls the clot not the dangerous part of the story. A strangulated hemorrhoid, on the same page, is an internal hemorrhoid whose blood supply is cut off, which can cause extreme pain. The longer complication list, including anemia, is on hemorrhoid complications. Which office procedure the treatment pages attach to a clot, and which they attach to an internal hemorrhoid, is on office treatments for hemorrhoids.