Internal hemroids are located inside the anus are not visible by the naked eye and can not be felt by fingers. They are caused by swelling and inflammation of the internal hemorrhoidal veins and present mainly by painless bleeding from the anus during passing stools. In internal hemroids, pain is usually mild or absent unless the hemroids are prolapsed through the anus and in this case they are called “prolapsed internal hemroids” where they may cause severe pain.

External hemroids are located outside the anus and are visible and palpable as a painful and tender mass. They are caused by swelling and inflammation of the external hemorrhoidal veins. In external hemroids, pain is the main complaint while bleeding is usually absent or mild unless the hemroids rupture which may be caused by the passage of hard stools.