The type of hemorrhoid depends on where it occurs. There are two types of hemorrhoids: internal and external.
External hemorrhoids develop around the rim of the anus. External hemorrhoids cause most of the symptoms associated with hemorrhoids (pain, burning, and itching) because the skin around them is very sensitive. If an external hemorrhoid becomes strangulated (cut off from blood supply), a clot can form in it and become an excruciatingly painful thrombosed hemorrhoid. Thrombosis of an external hemorrhoid causes an anal lump that is very painful and often requires medical attention.
Internal hemorrhoids develop inside the passageway of the anus. Internal hemorrhoids are often present without causing any discomfort or even awareness of their presence. Internal hemorrhoids are usually painless, although they sometimes cause discomfort and bleeding if a hard stool rubs against them during a bowel movement. Internal hemorrhoids also may prolapse outside the anus, where they appear as small, grape-like masses. These can be painful. A prolapsed hemorrhoid will go back inside the rectum on its own, or you can gently press it back into the anus with your fingertips.
