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When a patient has external hemorrhoids, they will lie under the skin around the anus. They can become very itchy and may bleed. Sometimes, the blood may accumulate and form a thrombus (clot), which can be painful; the area will swell and become inflamed. External hemorrhoids are more likely to present with pain.
Internal hemorrhoids are often painless but they sometimes cause a lot of bleeding. The internal veins may stretch and even fall out (prolapse) through the anus to outside the body. The veins may then become irritated and painful. emorrhoids are swollen veins and tissue in the lower rectum and anus. The anus is at the end of the rectum and is the opening through which bowel movements pass from your body. Hemorrhoids are a common problem. Another name for them is piles.