Hemorrhoids, What Does it Mean if They Are Internal, External, or Prolapsed?

Patient looking for hemorrhoid relief

Hemorrhoids are the inflamed veins around your anus, particularly in your lower rectum. They occur either inside or just under the skin around the anus. They may vary in size and become swollen because of increased blood flow. They may also stretch or bulge from internal pressure.

There are three different types:

  • External hemorrhoids: typically form outside of the anus at their point of origin. 
  • Internal hemorrhoids: these hemorrhoids form within the mucous lining that forms the wall of your rectum. 
  • Prolapsed hemorrhoid: this is external hemorrhoid that has dropped down through your anal canal to hang out on top of your anus for all to see.

The first type of hemorrhoid is external. They can be seen hanging out around your anus. They may look slightly swollen, red, and irritated.

The second type is Internal hemorrhoid. An internal hemorrhoid forms within the wall that makes up the mucous lining in your rectum or lower intestinal tract. You can see them bulging out from inside your anus. They are harder to identify because they’re not visible outside.

If you have them, you’ll likely feel painful pressure near your anus, which will worsen when you sit down or stand up after a long period of sitting down.

The third type is a Prolapsed hemorrhoid. They form like an internal hemorrhoid, except it has slipped out of the anal canal. To find this hemorrhoid, you’ll need to look around your anus for swollen red tissue hanging down toward your anus. They will be more visible than internal hemorrhoids because they’re outside of your body

What are external hemorrhoid symptoms?

External hemorrhoids can be uncomfortable and may cause bleeding during bowel movements or when wiping after using the bathroom. You may also feel pain around your rectum, which may worsen when trying to poop. External piles are typically not painful unless they develop a blood clot (thrombosed external hemorrhoid). If so, they will feel like a hardball around the anus.

What are internal hemorrhoid symptoms?

Internal piles can get bigger and form clots that cause pain and discomfort. The pain from internal piles is generally dull and constant, not sharp and sudden the way they typically present themselves. You may notice bright red blood during bowel movements or after wiping yourself.

At times there may be blood on your toilet paper when you wipe after pooping. If you have an external pile that becomes thrombosed, you’ll likely experience severe pain that makes sitting difficult and almost impossible without relief.

How do you remove external hemorrhoids?

To remove External piles, try using cold compresses such as ice packs or bags of frozen peas. Sitting in a lukewarm bath may also help reduce the pain and swelling. You can also try creams to soothe the pain.

How do you remove internal hemorrhoids?

To treat internal hemorrhoids, sit in a tub half-filled with warm or hot water for 15 minutes several times per day, or make three or four daily visits to the bathroom for your own personal “sitz bath.” Cold compresses will offer little relief if the piles are inside, but there are other options available when dealing with this type of pain. To relieve thrombosed external hemorrhoids, take ibuprofen at 800 milligrams three times each day until the symptoms disappear.

If they are very painful, apply a cream containing hydrocortisone to the affected area. Wait 15 minutes, and then pat dry with a clean towel. Apply petroleum jelly to the areas that have been cleaned before applying the cream. Ensure your bowels move by taking fiber supplements or drinking prune juice every day until you get results.

Your doctor may treat internal piles using rubber band ligation or sclerotherapy. Rubber band ligation involves placing rubber bands around them to cut off their blood supply, causing them to shrink and shrivel away over time.

During sclerotherapy, doctors inject chemicals into rectal veins to cause them to collapse and lose their ability to hemorrhage. You can treat piles using home remedies or store-bought medications. There are many treatments available over the counter, but if you’re suffering from severe pain, it’s important to see your doctor for proper diagnosis and treatment.

Ask your doctor about HemWell, an FDA-approved, pain-free treatment that’s permanent. If your provider doesn’t offer HemWell, we can assist you in finding one that does. Please visit our website to learn more about this life-changing treatment. Learn more about hemorrhoids.