Hemorrhoids commonly will cause protrusion, bulging, itching, and bleeding, sometimes even pain. There is a difference between internal and external hemorrhoids, external hemorrhoids are the ones on the outside of the anus. Patients will know about them because they typically will have folds or bulges in the skin, the external hemorrhoids are innervated much like the rest of the skin on the body so that if one were to have a cut or a pinch or pull at the external hemorrhoid it hurts very badly.

Internal hemorrhoids are further inside of the anal canal, the internal hemorrhoids live there and there are no sharp pain, sensation, nerves so if there is a bulge for example at the level of the internal hemorrhoids, a patient might have a feeling that they haven’t completely emptied their rectum after a bowel movement.


Your doctor might be able to see external hemorrhoids. Diagnosing internal hemorrhoids might include examination of your anal canal and rectum.

  • Digital examination: Your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths.
  • Visual inspection: Because internal hemorrhoids are often too soft to be felt during a rectal exam, your doctor might examine the lower portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope.

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