Hemorrhoids are swollen veins in the rectal or anal area, and they are generally categorized into two main types: internal and external hemorrhoids.
The most important distinction is location, which directly affects symptoms, discomfort, and treatment options.
- Internal hemorrhoids develop inside the rectum
- External hemorrhoids form under the skin around the anus
At USA Hemorrhoid Centers, treatment is primarily focused on internal hemorrhoids, especially when symptoms like rectal bleeding or prolapse become persistent with Hemorrhoid Artery Embolization.
Different Types of Hemorrhoids
Based on where they develop and how they behave. Understanding the differences helps explain why symptoms varyand why treatment approaches are not the same.
Internal Hemorrhoids
Location: Inside the rectum (above the anal canal)
Pain level: Usually painless
Main symptom: Bleeding
Key Characteristics
- Often cause bright red rectal bleeding
- May prolapse (bulge out of the anus as they worsen)
- Typically not painful because of fewer pain-sensitive nerves
- Can progress from mild to more severe stages over time
Why They Matter Most
Internal hemorrhoids are:
- The most common type
- The main cause of painless rectal bleeding
- The primary type treated with minimally invasive procedures like Hemorrhoid Artery Embolization (HAE)
Internal Hemorrhoids Information
Stages of Internal Hemorrhoids
Internal hemorrhoids are often classified by severity:
- Grade I: No prolapse, bleeding may occur
- Grade II: Prolapse during straining but retracts on its own
- Grade III: Prolapse that requires manual repositioning
- Grade IV: Permanently prolapsed and cannot be pushed back
As hemorrhoids progress, symptoms typically become more noticeable and disruptive.
Prolapsed Hemorrhoids (Advanced Internal Hemorrhoids)
Location: Start internally but extend outside the anus
Pain level: Can become uncomfortable or painful
Main symptom: Bulging tissue + bleeding
Key Characteristics
- Begin as internal hemorrhoids but push outward
- May go back in on their own (early stages) or stay outside permanently (advanced stages)
- Often associated with:
- Pressure
- Discomfort
- Hygiene challenges
- Ongoing bleeding
External Hemorrhoids
Location: Under the skin around the anus
Pain level: Often painful
Main symptom: Discomfort, swelling, irritation
Key Characteristics
- Can feel like a lump or swelling near the anus
- Often cause itching, irritation, or pain
- May bleed, but less commonly than internal hemorrhoids
- Pain is more noticeable due to sensitive nerve endings
Thrombosed External Hemorrhoids
In some cases, a blood clot can form inside an external hemorrhoid, leading to a a subtype.
A subtype where a blood clot forms:
- Causes sudden, severe pain
- Leads to a firm, tender lump
- Requires a different treatment approach
These are treated differently and require a medical evaluation for best course of action.
Key Differences Hemorrhoid Types:
| Feature | Internal Hemorrhoids | External Hemorrhoids | Prolapsed Hemorrhoids |
|---|---|---|---|
| Location | Inside rectum | Outside anus | Internal → outside |
| Pain | Rare | Common | Can develop |
| Bleeding | Common | Less common | Common |
| Visible | No (early stages) | Yes | Yes |
| Main Issue | Bleeding | Pain/discomfort | Bulging + bleeding |
Why This Difference Matters for Treatment
Not all hemorrhoids are treated the same way.
- Internal hemorrhoids → Often treated with minimally invasive procedures like HAE
- External hemorrhoids → Usually managed with symptom relief or other interventions
- Thrombosed hemorrhoids → May require urgent or different care
This is why proper diagnosis is critical—especially when symptoms like rectal bleeding are involved
Frequently Asked Questions About Hemorrhoid Types
Are internal hemorrhoids more serious than external hemorrhoids?
Not necessarily, but internal hemorrhoids are more likely to cause bleeding and chronic symptoms, which often require treatment.
Can you have both types at the same time?
Yes. Some patients experience both internal and external hemorrhoids.
Do all hemorrhoids need treatment?
No. Mild cases may improve with lifestyle changes, but persistent symptoms should be evaluated.
How do I know which type I have?
A medical evaluation is the best way to determine the type and severity of hemorrhoids.
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I highly recommend this place to anyone. Everyone was super friendly and professional and made my whole experience better than I could have expected. If you need a Hemorrhoid Artery Embolization, I highly recommend.
That’s a good place to receive better treatment of Hemorrhoids. You will get a good care of what you are looking for. Dr. Aaron D. Reichman is an amazing person.
Everything done professionally and the staff was super friendly and attentive!
USA Hemorrhoid Centers was very friendly and professional. Getting appointments, making any adjustments, and check in was very easy. My HAE procedure was delayed due to a snow storm. Althought it was an inconvenience, the office reached out to me and did everything possible to reschedule and assist me. I was able to get my procedure done the next day! Dr. Reichman is an excellent doctor. Friendly, knowledgeable, and very experienced in hemorrhoid artery embolization. I felt comfortable the whole time, from consultation to post-procedure. Couldn't have had a better experience.
It was a very good experience from the attention with the nurses and the doctor!
The doctor was great. Very good experience. My procedure was a success, they are very pleasant, helpful and respectful to me and my husband.
The doctor and staff are wonderful. it was my first procedure ever and they made me very comfortable with explaining the procedure step by step. Also, his assistant was very nice. She took very good care of me and I appreciate her so much! 10/10 recommend.
The staff was very helpful and professional. The doctor explained the procedures and he helped me make the best decision.
The doctor was wonderful. He explained all symptoms and detailed the procedure. After receiving my treatment, I feel much much better! USA Hemorrhoid Centers, Dr. H and his staff are excellent!!!!
I recently underwent a nonsurgical procedure that provided better results than the surgeries I already had to address the issues. Dr. Taghipour expertly walked me through each step and patiently answered all my questions. The procedure was comfortable with minimal downtime, and I noticed positive results quickly. The office was modern and clean, while the nurses provided attentive, personalized care. I highly recommend this nonsurgical option and Dr. Taghipour’s practice to anyone with similar concerns.
Great experience!!! This is the place to go to if you are dealing with hemorrhoids issues!
The staff was very helpful and professional. The doctor explained the procedures and he helped me make the best decision.
Dr G and whole staff are incredible. My hemorrhoid procedure was completely painless and effective
Ivan G.
They explained everything I needed to know about the HAE procedure in a very easy-to-get way, by the time of the procedure, I had no fear or doubt that I was on the right place.
Abe K.
I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.
USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.