How to Identify Hemorrhoids, Internal & External

Medically reviewed by: Gary H. Hoffman, MD

Identifying Hemorrhoids in Los Angeles: External or Internal?About 75 percent of Americans will develop hemorrhoids at some point in their lives, yet many people may not know that there are two varieties of this common problem. Though external and internal hemorrhoids are caused by the same factors, their symptoms can be very different—knowing the signs of each can help you stay free of them and seek treatment for hemorrhoids in Los Angeles as soon as you need it.

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External hemorrhoids are usually the easiest to identify, as they are often clearly visible. The signs of an external hemorrhoid include:

  • A painful, swollen vein visible on or around the anus. When an external hemorrhoid becomes thrombosed, it may bleed and turn blue or purple, or in some cases, it may burst.
  • Bleeding. You may notice blood on your toilet paper, and if you do, you should always seek immediate medical attention.
  • Itching. The area around an external hemorrhoid may become irritated and inflamed.

If you believe you may have an external hemorrhoid, your colorectal specialist will likely be able to diagnose it with nothing more than a visual or physical examination, but internal hemorrhoids may be a bit trickier to diagnose. Internal hemorrhoids often do not produce symptoms because they form inside the rectum, where there are fewer pain-sensing nerves to indicate their presence. Still, there are several telltale signs of internal hemorrhoids that may help you identify the problem:

  • Bleeding. As with external hemorrhoids, you may notice blood on your toilet paper after using the bathroom, and this is often the only sign that internal hemorrhoids produce. If you notice blood on your toilet paper without a clearly visible hemorrhoid, you may need additional screening for internal hemorrhoids.
  • Throbbing. If you have an internal hemorrhoid, you may notice a throbbing sensation in the anal area. You may also experience itching and skin irritation.
  • Prolapse. Not all internal hemorrhoids stay within the rectum—when an internal hemorrhoid prolapses, it will bulge through the anus and you may be able to feel or see it. When this happens, the hemorrhoid becomes much more painful and may be moister and pinker than the surrounding tissue.

Because internal hemorrhoids usually can’t be seen from the exterior, your colorectal specialist may need to use an anoscope to examine your rectum and confirm the presence of an internal hemorrhoid.

If you exhibit any of the signs of external or internal hemorrhoids, it is important to see a medical professional immediately. Rectal bleeding in particular may be indicative of a more serious problem and makes examination a necessity.

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