From the Guidelines
The primary distinction between internal and external hemorrhoids lies in their location, symptoms, and treatment options, with internal hemorrhoids being generally painless and external hemorrhoids causing significant pain, especially when thrombosed. The differences between internal and external hemorrhoids can be outlined as follows:
- Internal hemorrhoids:
- Develop inside the rectum
- Typically painless, but may cause bright red bleeding during bowel movements
- Can prolapse or protrude outside the anus, potentially becoming painful
- Classified into four degrees based on symptoms, with first-degree hemorrhoids bleeding but not protruding, and fourth-degree hemorrhoids being irreducible 1
- External hemorrhoids:
- Form under the skin around the anus
- Usually asymptomatic unless thrombosis occurs, leading to acute pain
- Often appear as bluish, tender lumps
- May require surgical drainage if thrombosed, especially within the first 72 hours for pain relief The location of hemorrhoids relative to the dentate line determines their classification as internal or external, with external hemorrhoids becoming symptomatic primarily when thrombosed or when skin tags interfere with hygiene 1.
From the Research
Differences between Internal and External Hemorrhoids
- Definition and Origin:
- Symptoms:
- Treatment:
- Classification: Hemorrhoids can be classified into three types: internal, external, and internal-external (mixed) 3
- Therapeutic Options: Various therapeutic options are available for hemorrhoids, and the severity of hemorrhoidal disease determines the proper therapy 3