Symptoms of internal hemorrhoids include "itching, bleeding, swelling, mucus discharge, burning sensation, prolapse, and soiling". Patients also complain of general discomfort while sitting, feeling of fullness and presence of a foreign body inside the anus. Internal hemorrhoids can only cause painless bleeding from the anus, while external hemorrhoids are painful. External hemorrhoids are located on the outside of the anus. They look like a bluish lump. But sometimes internal hemorrhoids can also become extremely painful. This happens because they develop a clot. In these cases, a thrombosed hemorrhoid occurs and it may have to be operated. Pain in the area around the anus may be due to another disease, such as anal fissure, anal fistula, or proctitis.